Sterile barrier systems for robotic surgery systems

ABSTRACT

A sterile barrier system for a robotic surgery apparatus can include a drape coupler. The drape coupler can include an external surface configured to face a first surface of a first portion of the robotic surgery apparatus. The drape coupler can include at least one drape coupler fastener positioned at least partially on the external surface and configured to removably attach the drape coupler to the first surface. The drape coupler can be configured to at least partially cover the first surface. The system can include a drape made of a flexible material and coupled to the drape coupler, the drape configured to wrap around a second surface of the first portion of the robotic surgery apparatus, the second surface different from the first surface. The drape coupler and the drape can be sterile.

TECHNICAL FIELD

This disclosure relates generally to robotic surgery systems and moreparticularly to sterile barrier systems and methods for such systems.

DESCRIPTION OF RELATED ART

Preventing surgical site infection in the operating room is one of themost important goals of a surgical team. Typically, the surgical teamaccomplishes this goal by creating and maintaining a sterile field,which can include environmental cleaning, disinfection, andsterilization of instruments. Creation and maintenance of the sterilefield can impose the requirement that all items used within a sterilefield remain sterile. When a robotic surgery system is used in theoperating room, creation and maintenance of sterile field can present anumber of challenges that have not been resolved by existing approaches.For example, due to the size and complexity, it may not be possible tosterilize the entire robotic surgery system. In many cases, partialsterilization may not be feasible or effective. The present disclosureovercomes these and other problems associated with known approaches forcreating and maintaining sterility of a robotic surgery system used inthe operating room.

SUMMARY

A sterile barrier system (or a sterile barrier) for a robotic surgeryapparatus can include a drape coupler. The drape coupler can include anexternal surface configured to face a first surface of a first portionof the robotic surgery apparatus. The drape coupler can include at leastone drape coupler fastener positioned at least partially on the externalsurface and configured to removably attach the drape coupler to thefirst surface. The drape coupler can be configured to at least partiallycover the first surface. The system can include a drape made of aflexible material and coupled to the drape coupler, the drape configuredto wrap around a second surface of the first portion of the roboticsurgery apparatus, the second surface different from the first surface.The drape coupler and the drape can be sterile.

The system (or barrier) of any of the preceding paragraphs and/or any ofthe systems described herein can include one or more of the followingfeatures. The first portion of the robotic surgery apparatus can includea manipulator unit. The first surface can include a manipulating surfaceof the manipulator unit. The at least one drape coupler fastener can beconfigured to removably attach the drape coupler to the manipulatingsurface of the manipulator unit. The second surface can include at leastone side surface of the manipulator unit. The drape can be configured toenclose the at least one side surface of the manipulator unit. The atleast one drape coupler fastener can include ferromagnetic materialconfigured to be attached to a magnet positioned on the first surface.The at least one drape coupler fastener can include a plurality offasteners with ferromagnetic material and configured to be attached to aplurality of magnets positioned on the first surface. The drape can becoupled to the drape coupler along a perimeter of the drape coupler. Thedrape can include an opening configured to expose a surgical instrumentinterface of the first portion of the robotic surgery apparatus. Thesurgical instrument interface can be configured to cause actuation of asurgical instrument. The drape coupler can include at least oneremovable protector configured to cover the opening of the drapecoupler.

The system (or barrier) of any of the preceding paragraphs and/or any ofthe systems described herein can include one or more of the followingfeatures. The drape coupler can include at least one region made atleast partially of flexible material. The at least one region can bepositioned adjacent to the opening and configured to collapse andexpand. The at least one region can include first and second regions.The first region can be positioned adjacent to a first side of theopening. The second region can be positioned adjacent to a second sideof the opening opposite the first side. The first and second regions canbe configured to collapse and expand in response to movement of theopening. The at least one region can include an insert made at leastpartially of material that is more rigid than the material of the atleast one region. The insert can be configured to cause the flexiblematerial of the at least one region to fold when the at least one regionis collapsed. The insert can include at least one tapered edge.

A kit can include a system (or barrier) of any of the precedingparagraphs and/or any of the systems described herein. A kit can includea sterile adapter configured to be received at (or fit into, or cover)the opening and to be removably attached to the surgical instrumentinterface. The sterile adapter can be configured to provide a sterilebarrier between the surgical instrument interface and a surgicalinstrument.

The kit of the preceding paragraph and/or any of the kits describedherein can include one or more of the following features. The sterileadapter can include a plurality of actuator covers configured to coupleto a plurality of instrument actuators positioned on the surgicalinstrument interface. The actuator covers can be configured to move inat least one direction to facilitate at least one of movement orarticulation of the surgical instrument mounted to the surgicalinstrument interface. The actuator covers can be positioned in a firstposition prior to positioning the cover on the surgical instrumentinterface. The actuator covers can be configured to be aligned in thefirst position. The sterile adapter can include a retainer surroundingthe actuator covers. The retainer can be configured to maintainpositioning of the actuator covers in the first position. The retainercan be removable to permit at least one of the actuator covers to bemoved to a position different than the first position.

The system (or barrier) of any of the preceding paragraphs and/or any ofthe systems described herein can include one or more of the followingfeatures. The drape can include at least one drape fastener configuredto removably attach the drape to a second surface of the first portionof the robotic surgery apparatus. The at least one drape fastener caninclude a bendable material and is configured to be wrapped around atleast one protrusion on the second surface. The drape can include afirst region including a first drape fastener and a second regionincluding a second drape fastener. The first region can be configured tobe positioned over the second region and fastened to the second regionby attachment of the first drape fastener to the second drape fastener.The drape can include a cover made of a material more rigid than theflexible material of the drape. The cover can be configured to enclose apin positioned on the second surface and configured to be inserted intoan opening of at least one of a surgical instrument insertion device ora camera insertion device of the robotic surgery apparatus. The covercan be configured to provide a sterile barrier between the pin and theopening. The drape can include an insert made of a material more rigidthan the flexible material of the drape. The insert can be configured tobe positioned in an opening in the first portion of the robotic surgeryapparatus that receives a portion of an endoscopic camera of the roboticsurgery apparatus. The insert can be configured to provide a sterilebarrier between the endoscopic camera and the first portion. The insertcan include first and second elongated side surfaces connected at oneend and not connected at an opposite end to form an opening. The openingcan be configured to be inserted into the opening of the first portionand to receive the endoscopic camera.

The system (or barrier) of any of the preceding paragraphs and/or any ofthe systems described herein can include one or more of the followingfeatures. The drape can include a first pocket configured to receive andat least partially enclose a first hand of a user. The first pocket canbe configured to facilitate positioning of the drape on (and/or,optionally, maintain sterility of the drape during attachment of thedrape to) the first portion of the robotic surgery apparatus. The drapecan include a second pocket configured to receive and at least partiallyenclose a second hand of a user. The second pocket can be configured tofacilitate positioning of the drape on (and/or, optionally, maintainsterility of the drape during attachment of the drape to) the firstportion of the robotic surgery apparatus. The second pocket can distinctfrom the first pocket. The first and second pockets can be positioned toallow a user to lift the drape away from the second surface whilemaintaining a sterile barrier for the first portion of the roboticsurgery apparatus. The drape coupler can be made from material that ismore rigid that the flexible material of the drape. The manipulator unitcan be hexahedron shaped and the manipulating surface of the manipulatorunit can be a bottom surface of the manipulator unit.

An instrument adapter for a robotic surgery apparatus can include ahousing configured to receive and support an actuator housing of asurgical instrument. The actuator housing can include a plurality ofsurgical instrument actuators. The adapter can include a plurality ofinterface actuators configured to engage with the plurality ofinstrument actuators of the actuator housing and cause movement of theinstrument actuators. Movement of the instrument actuators can causemovement of an end effector of the surgical instrument. The adapter caninclude a guide configured to receive the actuator housing of thesurgical instrument and allow the actuator housing to move (for example,forward and backward, side to side, or otherwise from one position toanother position) within the housing. The guide can be configured toallow the actuator housing to be positioned in the housing in a firstorientation in which the interface actuators are not engaged with theinstrument actuators of the surgical instrument, thereby facilitatingremoval of the actuator housing from the housing. The adapter caninclude a fastener configured to engage the actuator housing of thesurgical instrument. The fastener can be configured to transition from afirst position in which the actuator housing is positioned in the firstorientation to a second position in which the actuator is positioned ina second orientation in which the interface actuators are engaged withthe instrument actuators of the surgical instrument. The transition ofthe fastener from the first position to the second position can cause arotation of the actuator housing.

The adapter of the preceding paragraph and/or any of the adaptersdescribed herein can include one or more of the following features. Theguide can be configured to receive the actuator housing at an angle. Aplane in which the guide is oriented can be tilted relative to a planein which the interface actuators are oriented. Interface actuators canbe oriented in a horizontal plane. The fastener can include a latchconfigured to be locked when the fastener is in the second position. Thefastener can be configured to transition from the first position to thesecond position to cause rotation of the actuator housing. The fastenercan include a protrusion configured to engage with an opening in theactuator housing of the surgical instrument and cause the actuatorhousing to be rotated. The guide can be configured to not support theactuator instrument housing when the housing is rotated. At least one ofthe interface actuators can include a distal end configured to face acorresponding instrument actuator opening and a proximal end oppositethe distal end. The at least one interface actuator can be taperedtoward the distal end. The interface actuators are configured to engagewith the instrument actuators of the surgical instrument and move from afirst position to a second position to cause the instrument actuators tocorrespondingly move from the first position to the second position.Movement of the instrument actuators can cause movement of the endeffector. The adapter can be sterile.

The adapter of any of the preceding paragraphs and/or any of theadapters described herein can include one or more of the followingfeatures. The interface actuators can be positioned in a top portion ofthe housing. The guide can be positioned in a first portion of a side ofthe housing. The fastener can be positioned in a second portion of theside of the housing.

A manipulator unit of a robotic surgery apparatus can include a surgicalactuation interface configured to receive the instrument adapter of anyof the preceding paragraphs and/or any of the instrument adaptersdescribed herein.

A method of positioning a surgical instrument in a robotic surgeryapparatus can include positioning an instrument interface on the roboticsurgery apparatus. The instrument interface can include a housingincluding a plurality of interface actuators configured to cover (orcovering) a plurality of instrument actuators of the robotic surgeryapparatus. The method can include inserting an actuator housing of thesurgical instrument into the housing of the instrument interface. Themethod can include rotating the actuator housing within the housing ofthe instrument interface to cause a plurality of instrument actuators ofthe surgical instrument to engage with the plurality of instrumentactuators of the robotic surgery apparatus covered by the plurality ofinterface actuators of the instrument interface. Actuation of theinstrument actuators of the robotic surgery apparatus can causecorresponding actuation of the instrument actuators. Actuation of theinstrument actuators of the robotic surgery apparatus can cause movementof an end effector of the surgical instrument.

The method of the preceding paragraph and/or any of the methodsdescribed herein can include one or more of the following features.Inserting the actuator housing of the surgical instrument into thehousing of the instrument interface can include inserting the actuatorhousing at an angle relative to a plane in which the interface actuatorsare oriented. Inserting the actuator housing at the angle can includeguiding the actuator housing through a slot of the housing oriented in aplane that is at the angle relative to the plane in which the interfaceactuators are oriented. The method can include guiding the actuatorhousing past the slot of the housing into a portion of the housingadjacent to the slot. When the actuator housing is not rotated, theplurality of instrument actuators of the robotic surgery apparatus(which may be covered by the plurality of interface actuators of theinstrument interface) may not be not engaged with the instrumentactuators of the surgical instrument. Rotating the actuator housing caninclude operating a fastener of the instrument interface. Operating thefastener can include moving the fastener upward and locking a fastenerlatch. The method can include removing the actuator housing from thehousing of the instrument interface by unlocking the latch. Unlockingthe latch can cause the fastener to move downward and causes theactuator housing to rotate. Rotating the actuator housing can includerotating the actuator housing about an axis traversing a center of ashaft of the surgical instrument, the shaft connecting the actuatorhousing to the end effector. The instrument interface can be sterile.

An instrument adapter for a robotic surgery apparatus can include anadapter housing configured to receive and support an actuator housing ofa surgical instrument. The actuator housing can include a plurality ofsurgical instrument actuators. The adapter can include a plurality ofinterface actuators configured to engage with the plurality ofinstrument actuators of the actuator housing and cause movement of theinstrument actuators. Movement of the instrument actuators can causemovement of an end effector of the surgical instrument. The instrumentadapter can be configured to facilitate the actuator housing of thesurgical instrument to transition from a first orientation in which theinterface actuators are not engaged with the instrument actuators of thesurgical instrument to a second orientation in which the interfaceactuators are engaged with the instrument actuators.

The adapter of any of the preceding paragraphs and/or any of theadapters described herein can include one or more of the followingfeatures. Transition of the actuator housing from the first orientationto the second orientation can include rotation of the actuator housing.The adapter can include a guide configured to facilitate movement of theactuator housing at an angle. The guide can be oriented in a plane thatis tilted relative to a plane in which the interface actuators areoriented. Interface actuators can be oriented in a horizontal plane. Alength of the guide can be smaller than a length of the actuator housingof the surgical instrument. The adapter can include a fastenerconfigured to engage the actuator housing of the surgical instrument andcause the actuator housing to transition from the first orientation tothe second orientation. The fastener can include a protrusion configuredto engage with a groove in the actuator housing of the surgicalinstrument. The adapter can be configured to facilitate the actuatorhousing of the surgical instrument to transition from the secondorientation to the first orientation. The adapter can be sterile.

A method of preparing a robotic surgery apparatus for a medicalprocedure (or a method of draping the robotic surgery apparatus) caninclude covering a manipulator unit of the robotic surgery apparatuswith a first sterile barrier. Covering the manipulator unit can includecoupling a drape coupler of the first sterile barrier to a bottomsurface of the manipulator unit. Covering the manipulator unit caninclude wrapping a drape of the first sterile barrier around side andtop surfaces of the manipulator unit. The drape can be coupled to thedrape coupler. The drape can be made of material that is more flexiblethan material of the drape coupler. The method can include covering anarm of the robotic surgery apparatus supporting the manipulator unitwith a second sterile barrier that is distinct from the first sterilebarrier. Covering the arm can include coupling the second sterilebarrier to the arm. Covering the arm can include wrapping the secondsterile barrier around the arm.

The method of any of the preceding paragraphs and/or any of the methodsdescribed herein can include one or more of the following features. Thefirst and second sterile barriers can include sterile surfacesconfigured to face away from the robotic surgery apparatus. Covering thearm with the second sterile barrier can include covering a part of thedrape of the first sterile barrier with the second sterile barrier.Covering the part of the drape of the first sterile barrier with thesecond sterile barrier can facilitate independent movement of the secondsterile barrier without causing movement of the drape of the firststerile barrier. Covering the arm with the second sterile barrier caninclude coupling at least a part of the drape of the first sterilebarrier with at least a part of the second sterile barrier. Coupling thedrape coupler can include attaching at least one fastener of the drapecoupler to at least one fastener positioned on the bottom surface of themanipulator unit. Coupling the second sterile barrier can includeattaching at least one fastener of the second sterile barrier to atleast one fastener of the arm. The at least one fastener can bepositioned on a surface of the arm.

The method of any of the preceding paragraphs and/or any of the methodsdescribed herein can include one or more of the following features.Attaching the at least one fastener of the drape coupler to the at leastone fastener positioned on the bottom surface of the manipulator unitcan include causing magnetic coupling. Attaching the at least onefastener of the second sterile barrier to the at least one fastener ofthe arm can include causing magnetic coupling. The method can includecoupling a sterile adapter to an instrument interface positioned on thebottom surface of the manipulator unit. The instrument interface can beconfigured to support and actuate an instrument. The method can includecovering a pin of the manipulator unit with a sterile roller bypositioning the roller on the pin. The pin and roller can be configuredto cooperate to extend and retract a camera. The method can includeremoving first and second sterile barriers. The method can includecovering a patient cart of the robotic surgery apparatus with a thirdsterile barrier. Covering can include coupling the third sterile barrierto the patient cart. Coupling the third sterile barrier to the patientcart can include attaching at least one fastener of the third sterilebarrier to at least one fastener. The at least one fastener can bepositioned on or adjacent to a surface of the patient cart. Attachingthe at least one fastener of the third sterile barrier to the at leastone fastener of the patient cart can include causing magnetic coupling.Wrapping the drape of the first sterile barrier around side and topsurfaces of the manipulator unit can include coupling the drape to thetop surface of the manipulator unit. Coupling the drape of the firststerile barrier to the top surface of the manipulator unit can includecausing magnetic coupling.

A method of preparing a robotic surgery apparatus for a medicalprocedure (or a method of draping the robotic surgery apparatus) caninclude positioning a first sterile barrier on a first portion of therobotic surgery apparatus. Positioning the first sterile barrier caninclude coupling a drape coupler of the first sterile barrier to asurface of the first portion of the robotic surgery apparatus configuredto support at least one surgical instrument of the robotic surgeryapparatus. Positioning the first sterile barrier can include wrapping adrape of the first sterile barrier around one or more other surfaces ofthe first portion of the robotic surgery apparatus. The drape can becoupled to the drape coupler. The method can include positioning asecond sterile barrier that is distinct from the first sterile barrieron a second portion of the robotic surgery apparatus adjacent to thefirst portion of the robotic surgery apparatus. Positioning the secondsterile barrier can include coupling the second sterile barrier to thesecond portion. Positioning the second sterile barrier can includewrapping the second sterile barrier around the second portion.

The method of any of the preceding paragraphs and/or any of the methodsdescribed herein can include one or more of the following features.Material of the drape coupler can be more rigid than material of thedrape of the first sterile barrier. Positioning the second sterilebarrier can include covering a portion of the drape of the first sterilebarrier with the second sterile barrier. Covering can facilitateindependent movement of first and second sterile barriers. First andsecond sterile barriers can include sterile surfaces configured to faceaway from the robotic surgery apparatus. Coupling the drape coupler caninclude attaching at least one fastener of the drape coupler to at leastone fastener positioned on the surface of the first portion of therobotic surgery apparatus. Coupling the drape coupler can coupling thesecond sterile barrier can include attaching at least one fastener ofthe second sterile barrier to at least one fastener of the secondportion of the robotic surgery apparatus. The at least one fastener canbe positioned on or adjacent to a surface of the second portion. Themethod can include coupling a sterile adapter to an instrument interfacepositioned on the surface of the first portion of the robotic surgeryapparatus. The instrument interface can be configured to support andactuate the at least one surgical instrument. The method can includecovering a pin of the first portion with a sterile cover by positioningthe cover on the pin, the pin and cover configured to cooperate toextend and retract a camera. The method can include removing the firstand second sterile barriers.

The method of any of the preceding paragraphs and/or any of the methodsdescribed herein can include one or more of the following features. Themethod can include positioning a third sterile barrier on a thirdportion of the robotic surgery apparatus. The positioning can includecoupling the third sterile barrier to the third portion. Coupling thethird sterile barrier to the third portion can include attaching atleast one fastener of the third sterile barrier to at least one fastenerof the third portion. The at least one fastener can be positioned on oradjacent to a surface of the third portion. Attaching the at least onefastener of the third sterile barrier to the at least one fastener ofthe third portion can include causing magnetic coupling.

A sterile barrier for a robotic surgery apparatus can include a drapemade of a flexible material. The drape can include a first surfaceconfigured to face a component of the robotic surgery apparatus and asecond surface opposite the first surface. The second surface can besterile and configured to provide a sterile barrier for the component.The barrier can include a first pair of pockets positioned along a firstedge of the second surface and configured to receive hands of a user.The first pair of pockets can be configured to facilitate positioning ofthe sterile barrier on the component. The first pair of pockets can beconfigured to facilitating maintaining sterility of the second surfaceof the drape when the drape is attached to the component (and,optionally, when the drape is at least partially wrapped around thecomponent).

The barrier of any of the preceding paragraphs and/or any of thebarriers described herein can include one or more of the followingfeatures. The barrier can include a plurality of fasteners positioned onthe first surface of the drape. The fasteners can be configured toremovably position the drape on the component. The fasteners can includeferromagnetic material configured to be attached to at least one magnet(and/or a plurality of magnets) positioned on (or adjacent to) a surfaceof the component. At least one of the fasteners can be positioned in aregion of the drape that overlaps a pocket of the first pair of pockets.The first pair of pockets can include visual indicators, which may bepositioned on interior surfaces of the first pair of pockets. The visualindicators can be configured to guide the user to insert the hands in acorrect position into the first pair of pockets. The barrier can includea second pair of pockets positioned along the first edge of the secondsurface and configured to receive the hands of the user. The barrier caninclude a first fastener positioned on an exterior surface of a firstpocket of the first pair of pockets. The exterior surface of the firstpocket of the first pair of pockets can be part of the second surface ofthe drape. The barrier can include a second fastener positioned on anexterior surface of a second pocket of the first pair of pockets. Theexterior surface of the second pocket of the first pair of pockets canbe part of the second surface of the drape. The first and secondfasteners can be configured to be attached to another pair of fastenersto retain the drape wrapped around a portion of the component.

The barrier of any of the preceding paragraphs and/or any of thebarriers described herein can include one or more of the followingfeatures. The barrier can include a third fastener positioned on anexterior surface of a first pocket of the second pair of pockets. Thebarrier can include a fourth fastener positioned on an exterior surfaceof a second pocket of the second pair of pockets. The third and fourthfasteners can be configured to be attached to the first and secondfasteners to retain the drape wrapped around the portion of thecomponent. The barrier can include a drape coupler made of a materialmore rigid that the flexible material of the drape, wherein the drape iscoupled to the drape coupler. The barrier can include at least onefastener configured to be wrapped around a protrusion of the componentthereby tightening the drape around the protrusion. The barrier caninclude a second pocket positioned below a pocket of the first pair ofpockets. The second pocket can be configured to receive a first portionof the hand of the user to facilitate wrapping the drape at leastpartially around the component. The second pocket can be configured toreceive only the first portion of the hand but not the entire hand. Thebarrier can include a third pocket positioned along a second edge of thedrape that is opposite the first edge of the drape along which the firstpair of pockets is positioned. The third pocket can be configured toreceive a second portion of the hand of the user to facilitate wrappingthe drape at least partially around the component. The third pocket canbe configured to receive only the second portion of the hand but not theentire hand.

A kit can include first and second sterile barriers of any of thepreceding paragraphs and/or any of the sterile barriers describedherein. The first sterile barrier can include a first drape. The secondsterile can include a second drape. The first drape can be configured tocover the component. The second drape can be configured to cover asecond component of the robotic surgery apparatus adjacent to thecomponent. The second drape can be configured to cover a portion of thefirst drape.

The kit of the preceding paragraph and/or any of the kits describedherein can include one or more of the following features. The seconddrape can include first and second fasteners, which can be positioned onopposite sides of the second drape. The first and second fasteners canbe configured to be attached to each other to retain positioning of thesecond drape over the first drape. The kit can include at least onesterile cover configured to cover an instrument interface of thecomponent. The instrument interface can be configured to support andactuate a surgical instrument. The kit can include at least one sterileroller configured to cover a pin of the component. The pin and rollercan be configured to cooperate to extend and retract a camera. The kitcan include a third sterile barrier including a third drape. The thirddrape can be configured to be positioned on a third component of therobotic surgery apparatus and/or to provide a sterile barrier for thethird component.

A robotic surgery apparatus can include a component including a housingwith an external surface. The apparatus can include a plurality ofcomponent fasteners positioned on the external surface of the housing.The plurality of component fasteners can be configured to couple with aplurality of drape fasteners of a sterile drape. The sterile drape canbe configured to cover a portion of the surface of the housing and toprovide a sterile barrier for the portion of the surface. A number ofcomponent fasteners in the plurality of component fasteners can exceed anumber of drape fasteners in the plurality of drape fasteners,permitting the drape to be positioned on the housing of the component ina plurality of orientations and to cover a plurality of differentportions of the surface of the housing. When the drape is positioned onthe housing, at least one component fastener of the plurality ofcomponent fasteners may not be coupled to any of the drape fasteners ofthe plurality of drape fasteners.

The apparatus of any of the preceding paragraphs and/or any of theapparatuses described herein can include one or more of the followingfeatures. The component fasteners can be configured to support thedrape. At least one component fastener can include a magnet. Theexternal surface of the housing can include a recess. The magnet can beconfigured to be positioned in the recess. The recess can be configuredto receive a drape fastener. The magnet can be configured to bepositioned at a bottom of the recess. The recess can include at leastone wall oriented substantially perpendicular to a surface of the magnetconfigured to couple with the drape fastener. The apparatus can includeelectronic circuitry configured to detect positioning and orientation ofthe drape. The electronic circuitry can be configured to determine ifthe drape is correctly positioned and generate an indication in responseto a determination that the drape is not correctly positioned. Theelectronic circuitry can include at least one proximity sensor. Thecomponent can include a patient cart. The at least one componentfastener can include indicia on a surface of the at least one componentfastener. The indicia can be configured to facilitate coupling of adrape fastener.

A method of preparing a robotic surgery apparatus for a medicalprocedure (or a method of draping the robotic surgery apparatus) caninclude, from a plurality of sterile barrier positions, identifying adesired position of a sterile barrier on a component of the roboticsurgery apparatus. The method can include covering at least a portion ofa surface of the component with the sterile barrier by positioning thesterile barrier in the desired position. The positioning can includecoupling a plurality of sterile barrier fasteners to a subset of aplurality of fasteners of the component.

The method of any of the preceding paragraphs and/or any of the methodsdescribed herein can include one or more of the following features. Anumber of the fasteners of the component can exceed a number of thesterile barrier fasteners. Positioning the sterile barrier can includenot coupling any of the sterile barrier fasteners to at least onefastener of the component. The method can include removing the sterilebarrier by decoupling the plurality of sterile barrier fasteners fromthe subset of the plurality of fasteners of the component. The methodcan include verifying that the sterile barrier is correctly positionedbased on an output of an electronic circuitry of the robotic surgeryapparatus. The electronic circuitry can be configured to detect if thesterile barrier is correctly positioned in the desired position andoutput an indication that the sterile barrier is not correctlypositioned.

A robotic surgery apparatus can include a component including a housingwith an external surface. The apparatus can include a component fastenerpositioned on the external surface of the housing. The componentfastener can be configured to couple with a drape fastener of a steriledrape. The sterile drape can be configured to cover a portion of thesurface of the housing and to provide a sterile barrier for the portionof the surface. At least one dimension of the component fastener canexceed at least one corresponding dimension of the drape fastener,permitting the drape to be positioned on the housing of the component ina plurality of orientations and to cover a plurality of differentportions of the surface of the housing. The component fastener can beconfigured to support the drape.

The apparatus of any of the preceding paragraphs and/or any of theapparatuses described herein can include one or more of the followingfeatures. The at least one dimension can include length. The componentfastener can be configured to support the drape.

A method of preparing a robotic surgery apparatus for a medicalprocedure (or a method of draping the robotic surgery apparatus) caninclude, from a plurality of sterile barrier positions, identifying adesired position of a sterile barrier on a component of the roboticsurgery apparatus. The method can include covering at least a portion ofa surface of the component with the sterile barrier by positioning thesterile barrier in the desired position. The positioning can includecoupling a sterile barrier fastener to a component fastener of thecomponent. At least one dimension of the component fastener can exceedat least one corresponding dimension of the drape fastener.

The method of any of the preceding paragraphs and/or any of the methodsdescribed herein can include one or more of the following features. Theat least one dimension of the component fastener exceeding the at leastone corresponding dimension of the drape fastener can permit the drapeto be positioned in a plurality of orientations and to cover a pluralityof different portions of the surface of the component. The at least onedimension can include length. The component fastener can be configuredto support the drape.

Any of the sterile barriers and/or adapters of any of precedingparagraphs and/or described below can be used with any of the roboticsurgery system components.

In some cases, a robotic surgery system as described and/or illustratedis provided. In some cases, one or more sterile barriers as describedand/or illustrated are provided. In some cases, one or more sterileadapters as described and/or illustrated are provided. In some cases,one or more kits as described and/or illustrated are provided.

In some cases, a method of using and/or operating a robotic surgerysystem or any of its components as described and/or illustrated isprovided. In some cases, methods of preparing a robotic surgeryapparatus for a medical procedure as described and/or illustrated areprovided. Any of such methods can include positioning one or moresterile barriers and/or adapters on any of the components of the roboticsurgery system (or covering any of the components with any of thesterile barriers) as described and/or illustrated.

Any of the methods of any of the preceding paragraphs and/or describedherein can be used with any of the sterile barriers, adapters, kits,and/or robotic surgery systems.

BRIEF DESCRIPTION OF THE DRAWINGS

Embodiments of the present disclosure will now be described hereinafter,by way of example only, with reference to the accompanying drawings inwhich:

FIGS. 1A-1D illustrate a robotic surgery system;

FIGS. 2A-2G illustrate a sterile barrier for the robotic surgery system;

FIGS. 3A-3F illustrate a sterile barrier for a manipulator unit of therobotic surgery system;

FIGS. 4A-4O illustrate a sterile adapter for a surgical instrument;

FIG. 5 illustrates a sterile barrier for an elevating linkage assemblyof the robotic surgery system;

FIG. 6A illustrates a sterile barrier for a boom arm assembly of therobotic surgery system;

FIG. 6B illustrates various orientations of the sterile barrier of FIG.6A;

FIGS. 7A-7C illustrate labels;

FIGS. 8A-8W illustrate covering components of the robotic surgery systemwith one or more sterile barriers;

FIG. 9 illustrates fasteners of the robotic surgery system;

FIG. 10 illustrates sterile barrier kits;

FIG. 11 illustrates positioning of a sterile barrier on a roboticsurgery system component.

DETAILED DESCRIPTION Overview of Robotic Surgery System

Using a robotic surgery system in the operating room can require placingone or more components of the system within the sterile field in theoperating room, while placing other components of the system outside thesterile field. Creating and maintaining the sterile field in theoperating room when components of the robotic surgery system are presentcan be challenging. For example, non-sterile components of the system(such as, the workstation as described herein) may be placed outside thesterile field, and it is important to ensure that such components orconnections between non-sterile and sterile components do notcontaminate sterile items, personnel, or the patient within the sterilefield. As another example, sterilizing the one or more components of thesystem positioned within the sterile field may not be practical due tothe size and complexity of the one or more components. As describedherein, one or more sterile barriers covering one or more components ofthe system can be utilized to create and maintain the sterile field.

Referring to FIG. 1A, a robotic surgery system is shown generally at1000. In some implementations, the robotic surgery system 1000 can beconfigured to facilitate a medical procedure (for example, surgery)performed via one or more incisions. For a single incision, a singleaccess port can be inserted into the incision to provide access for oneor more instruments (sometimes referred to as surgical instruments,tools or surgical tools) or cameras (or other non-tissue manipulatingequipment, including advanced visualization equipment).

The system 1000 can include a workstation 102 and a patient cart 104.One or more of the patient cart 104 or the workstation 102 can bemoveable. The patient cart 104 can include a manipulator unit or centralunit 400 to which one or more instrument insertion and visualizationdevices 108 can be attached or mounted. The central unit 400 can besupported by an elevating linkage assembly 300 (sometimes referred to asan arm) connected to a boom arm assembly 200 (sometimes referred to as acolumn) of the patient cart. The central unit 400 can be moveable, suchas in three dimensions, to facilitate desired positioning of one or moresurgical instruments or cameras. Movement of the central unit 400 can befacilitated by one or more of the arm 300 and column 200. For example,the column 200 can facilitate vertical positioning of the central unit400, and the arm 300 can facilitate further vertical positioning inaddition to lateral movement and rotation of the central unit 400.

The instrument insertion and visualization device 108, which can beremovably mounted to the central unit 400, can support at least onesurgical instrument and one or more cameras (not shown) that image asite of interest, such as a surgical site. The instrument insertion andvisualization device 108 can support two or more instruments (notshown). The one or more cameras can include a primary camera and atleast one secondary camera. The primary camera and the secondary cameramay provide different viewing angles, perform different functions and/orproduce different images. At least one of the primary camera and thesecondary camera may be a two-dimensional (2D) or a three-dimensional(3D) camera.

The workstation 102 can include an input device 112 that receivesoperator input and produces input signals and may also be configured togenerate feedback to the operator or user. The feedback can be visual,auditory, haptic, or the like. The input device 112 can be implementedusing a haptic interface available from Force Dimension, of Switzerland,for example. The operator can be a surgeon.

The workstation 102 can further include electronic circuitry 114 incommunication with the input device for receiving the input signals andgenerating control signals for controlling the robotic surgery system,which can be transmitted to the patient cart 104 via an interface cable116. In some cases, data transmission can be wireless and the interfacecable 116 may not be present. The electronic circuitry 114 can includeone or more processors or controllers. The electronic circuitry 114 canfunction as a master for controlling movement of one or more surgicalinstruments or cameras mounted to the patient cart 104. The patient cartcan include electronic circuitry 118, which can include one or moreprocessors or controllers. The electronic circuitry 118 can function asa slave and be controlled by the electronic circuitry 114. Communicationbetween the electronic circuitry 114 of the workstation 102 and theelectronic circuitry 118 of the patient cart 104 may wired (such as, viathe cable 116) or wireless. The workstation 102 may be located remotelyfrom the patient cart 104, such as outside the operating room or in anon-sterile area of the operating room.

The input device can include a right input device 132 and a left inputdevice 112 for controlling respective right and left instruments (notshown). The right input device 132 can include a right hand controller122 (sometimes referred to as a hand grip or handpiece), and the leftinput device 112 can include a left hand controller 124. The right andleft hand controllers 122 and 124 can be mechanically and/orelectrically coupled to the respective input devices 132 and 112.Alternatively, the right and left hand controllers 122 and 124 may bewirelessly coupled to the respective input devices 132 and 112 or may bewireless coupled directly to the workstation 102. The right and lefthand controllers 122 and 124 can be grasped by the operator's hands andmoved to produce input signals at the respective input devices 132 and112.

In some cases, when there are two instruments at the patient cart 104,the right and left hand controllers 122 and 124 may respectively controlthe two instruments. In some cases, when there are more than twoinstruments, the right and left hand controllers 122 and 124 may be usedto select two of the multiple instruments that the operator wishes touse at any given time. In some cases, when there is only one instrument,one of the right and left hand controllers 122 and 124 may be used toselect the single instrument.

The input devices 132 and 112 may generate input signals representingpositions of the hand controllers 122 and 124 within an input deviceworkspace (not shown). In some cases where the input devices 132 and 112are coupled directly and wirelessly to the workstation, they wouldinclude the necessary sensors to allow wireless control such as anaccelerometer, a gyroscope and/or magnetometer. In other cases, awireless connection of the input devices 132 and 112 to the workstation102 may be accomplished by the use of camera systems alone or incombination with the described sensors. Such sensors for wirelessfunctionality may also be placed in each handpiece to be used inconjunction with the input devices 132 and 112 to independently verifythe input device data. The electronic circuitry 114 can be incommunication with the input devices 132 and 112 for receiving the inputsignals.

The electronic circuitry 118 of the patient cart 104 can receive controlsignals from the electronic circuitry 114 and produce slave controlsignals operable to control the instrument insertion and visualizationdevice 108 and one or more instruments (and their respective endeffectors) and/or cameras during a surgical procedure. The one or moreinstruments can include dexterous tools, such as grippers, needledrivers, staplers, dissectors, cutters, hooks, graspers, scissors,coagulators, irrigators, and suction devices used for performing asurgical procedure (such as a laparoscopic surgical procedure). Whileboth master and slave electronic circuitry 114 and 118 are illustrated,in some cases a single electronic circuitry may be used to perform bothmaster and slave functions.

The workstation 102 can also include a user interface, such as a display120 in communication with the electronic circuitry 114 for displayinginformation (such as, body cavity images) for a region or site ofinterest (for example, a surgical site, a body cavity, or the like) andother information to the operator. The display 120 can display real timeimages or other graphical depictions of a surgical site produced by oneor more cameras of the visualization device (not shown) and/or one ormore cameras of the instrument insertion and visualization device 108.The workstation 102 may include right and left graphical depictions (notshown) displayed on the display 120 respectively for the right and leftside instruments (not shown). The graphical depictions may be displayedat a peripheral region of the display 120 to prevent obscuring a liveview of the surgical workspace also displayed on the display. Thedisplay 120 may further be operable to provide other visual feedback orinstructions to the user.

The workstation 102 can include a second auxiliary display 123 todisplay auxiliary surgical information to the user, for example, patientmedical charts, pre-operation images and surgical data. In some cases,the auxiliary display 123 may be a touch display and may also beconfigured to display graphics representing additional inputs forcontrolling the workstation 102, the patient cart 104, and/or specificfunctions thereof.

The workstation 102 can also include one or more controllers, such asone or more footswitches or pedals 126, for controlling the roboticsurgery system. For example, one or more pedals 126 can include a clutchpedal that allows repositioning the hand controllers 122 or 124 withoutcorresponding movement of the respective associated instrument. Theclutch pedals 126 can provide input signals to the electronic circuitry114, and the electronic circuitry may inhibit movement of the associatedinstrument while the footswitch 126 is depressed.

FIG. 1B illustrates a close-up front perspective view of a portion ofthe patient cart 104. The illustrated portion includes the central unit400 (which can be shaped as a hexahedron), the arm 300, and an upperportion of the column 200. FIG. 1C illustrates a close-up rearperspective view of the portion of the patient cart 104 illustrated inFIG. 1B. The central unit 400 can include one or more attachments orfasteners 302 and 304, which can be positioned around the perimeter orcircumference of the central unit as illustrated (such as, on oppositesides) and/or positioned around the perimeter or circumference of alower portion of the arm 300 (proximate near where the central unit 400is attached, mounted, connected or otherwise coupled to the arm). Thearm 300 can include one or more attachments or fasteners 402, 404, and406, which can be positioned around the perimeter or circumference ofthe arm as illustrated. Fastener 402 can be positioned in the middle(for example, in line or substantially in line with a center of thecentral unit 400). Fasteners 404 and 406 can be positioned on the sides.The column 200 can include one or more attachments or fasteners 202,204, 206, and 208, which can be positioned on opposite sides (orotherwise spaced apart, for example, equally spaced apart) around theperimeter or circumference of the column as illustrated. As describedherein, the one or more attachments can be configured to facilitateattachment (such as, removable attachment) of one or more sterilebarriers, such as drapes, to cover (or enclose) the one or morecomponents of the patient cart 104. For example, any of the fastenerscan include a magnetic material for removably attaching or affixing asterile barrier, such as a drape. Attachment may be formed when anattachment portion of the drape that includes a ferromagnetic materialis brought into proximity of or into contact with a fastener. Any of thefasteners of the robotic surgery system components and/or sterilebarriers can be circular, rectangular, square, or the like. In somecases, one or more of the fasteners may be three-dimensionally shaped inaddition to having a shape. In some cases, the attachment portion of thedrape that includes the ferromagnetic material may bethree-dimensionally shaped. In some cases, there may be more or lessfasteners positioned on the one or more of components 400, 300, and 200than illustrated in FIGS. 1B-1C. In some cases, one or more fastenerscan be positioned in different locations. In some cases, one or morefasteners can be positioned on or adjacent to the surface of the roboticsurgery system component.

FIG. 1D illustrates the instrument insertion and visualization device108. The instrument insertion and visualization device 108 can includean insertion device 210 and a visualization device 220. The insertiondevice 210 can include a housing 212 and a plurality of passages,lumens, or channels 214 for inserting and guiding one or moreinstruments or cameras. The plurality of channels 214 can be enclosed inanother housing as illustrated in FIG. 1D. The two housings can beconnected as shown. The plurality of channels 214 can also permitinsertion of a primary camera 224. The primary camera be an endoscope orendoscopic camera. A distal end 224B of the primary camera 224 canextend beyond the housing including the plurality of channels 214. Atleast a portion of the distal end 224B can be positioned near or in thesite of interest (such as, to provide image data of the site ofinterest). One or more cameras (such as, imaging components, includingone or more lenses) can be positioned at the distal end 224B. Theprimary camera 224 can also include a proximal end 224A.

The visualization device 220 can include a housing 222 to which theproximal end 224A of the primary camera can be attached (removably ornon-removably). The housing 222 can include an opening in which one ormore sterile drivers, such as at least one of 232A or 232B (individuallyor collectively referred to as 232), can be positioned. The one or moredrivers 232 can contact or grip the primary camera 224 and move theprimary camera through the opening in the housing 222 and a channel ofthe plurality of channels 214 so that the distal end 224B extends awayfrom one or more of the housings 212 or 222 or retracts back toward orinto one or more of the housings 212 or 222. A camera tube 225 of theprimary camera 224 can form a loop around at least a portion of thehousing 222. The diameter of the loop can be increased when the distalend 224B is retracted toward or into one or more of the housings 212 or222 and be decreased when the distal end 224B is extended away from oneor more of the housings 212 or 222. In some cases, the visualizationdevice 220 may be coupled to another part of the insertion device 210.In some cases, the visualization device may not be coupled to theinsertion device 210 and instead be coupled to another part of thecentral unit 400. In some cases, the primary camera 224 may not includea loop and instead be linearly inserted into and through the insertiondevice 210 but otherwise have a distal end 224B of the primary camera224 function as described above.

At least a portion of the primary camera tube 225 can be flexible orsubstantially flexible in order to form the loop and/or be guidedthrough the one or more openings and/or channels as described herein. Insome cases, at least a portion of the primary camera tube 225 can beflexible or substantially flexible in order to facilitate manipulationof the primary camera at the site of interest, for example, to providethe operator with the desired camera view. In some cases, looping thecamera 224 upward around at least the portion of the housing 222 asdescribed can permit the primary camera to have sufficient length forreaching near and/or into the site of interest, while eliminating orreducing the risk of the primary camera 224 (or at least desired portionthereof) coming into contact with non-sterile object, such as the flooror a portion of the system 1000 not covered or protected by a sterilebarrier.

One or more cables 240 can be used to transmit control signals and data,such as analog or digital image data provided by the one or more cameraspositioned at the distal end 224B or in the insertion device 210, to thepatient cart 104 and/or the workstation 102. In some cases, transmissioncan be wireless and one or more cables 240 may not be present.

The insertion device 210 can include one or more instrument channels forpositioning one or more surgical instruments. The one or moreinstruments can be loaded (into the instrument channels) through one ormore openings 340 formed in the rear of the housing 212 of the insertiondevice 210. In some cases, one or more secondary cameras can beintegrated in the insertion device 210 or be removably positioned in theinsertion device.

In operation, the insertion device 210 and visualization device 220 canbe attached to each other. For instance, the housings 220 and 210 can beattached to each other. Attachment can be removable and can facilitateinsertion into and movement of the primary camera 224 (such as, thedistal end 224B) through the housings 220 and 210 and the channel of theplurality of channels 214. In some cases, the insertion device 210 canbe attached to a first portion of the central unit 400 while thevisualization device 220 can be attached to a second portion of thecentral unit, facilitating the entry of the primary camera 224 into andthrough the insertion device from a range of angle/orientations.

FIGS. 1A-1D illustrate an example of a robotic surgery system and itscomponents, and certain elements may be removed, other elements added,two or more elements combined, or one element can be separated intomultiple elements depending on the specification and requirements of therobotic surgery system.

Additional details of the robotic surgery system 1000 and itscomponents, including one or more insertion devices, visualizationdevices, or cameras, are described in U.S. patent application Ser. No.16/156,651 filed on Oct. 10, 2018, Ser. No. 16/156,625 filed on Oct. 10,2018, Ser. No. 16/174,646, filed on Oct. 30, 2018, Ser. No. 16/299,834,filed on Mar. 12, 2019, Ser. No. 16/419,743 filed on May 22, 2019, andSer. No. 16/419,696 filed on May 22, 2019, the entire disclose of eachof which is incorporated by reference and should be considered part ofthis specification.

Overview of Sterile Barrier

To establish and maintain sterility of one or more components of arobotic surgery system, such as the system 1000, one or more sterilebarriers, such as drapes, can be utilized. Such approach can be morepractical, efficient and/or effective to sterilizing the one or morecomponents of the robotic surgery system, such as sterilizing externalsurfaces and/or other parts of the one or more components. Attaching orpositioning of such barriers on the one or more components of therobotic surgery system is illustrated in FIGS. 2A-2G. As is illustrated,one or more sterile barriers can be removably attached or positioned tocover one or more components of the patient cart 104, which can bepositioned at least partially in the sterile field.

Sterile barriers can help to mitigate the risk of a sterile object orsterile personnel (such as, sterile nurse, surgeon, or the like) cominginto contact with a non-sterile surface or object. Sterile barriers canadditionally or alternatively protect components of the robotic surgerysystem from coming into contact with fluids or tissue during the medicalprocedure.

FIG. 2A illustrates an interface 500 of the central unit 400. Theinterface 500 (which can be referred to as a mounting interface) can beconfigured to support an instrument insertion and visualization device108, which can include the insertion device 210 and the visualizationdevice 220. The insertion device 210 can include the plurality ofchannels 214 for facilitating positioning adjacent to or in the site ofinterest of one or more surgical instruments and one or more cameras(including, the primary camera 224). The visualization device 220 canfacilitate positioning of the primary camera 224 adjacent to or in thesite of interest. In some cases, the primary camera 224 can be of lengthselected to allow at least the distal portion 224B of the primary camerato be advanced toward or into the site of interest and retracted awayfrom the site of interest (such as, toward or into a cannel of thevisualization device 220). As described herein, the primary camera 224can include the camera tube 225, a flexible or substantially flexibleportion, that forms a loop around a portion of the visualization device220, such as the housing 222. The looped portion of the primary cameracan be shortened when the primary camera is advanced and lengthened whenthe primary camera is retracted.

The mounting interface can include an opening or slit 504 for receivingthe looped portion of the primary camera. The interface 500 can includeone or more posts or pins 510 configured to actuate one or more drivers232 for advancing the primary camera 224 toward or into the site ofinterest and/or retracting the primary camera. The interface 500 caninclude a sterile cover 550 that can be attached to cover one or moreadditional posts or pins of the mounting interface 500. The one or morepins can be configured to support one or more of the insertion orvisualization devices.

One or more drivers 232 and cover 550 can be sterile and form part of asterile barrier for the central unit 400. A sterile barrier may need tobe provided between the mounting interface 500 of a non-sterile surfaceof the central unit 400 and one or more of a sterile insertion orsterile visualization devices, which can be removably attached to ormounted on the interface 500. The insertion and visualization devices210 and 220 may be required to be sterile (for example, to maintainsterility of one or more surgical instruments and/or cameras mounted toor positioned in the insertion and visualization devices) in order toprotect the site of interest from infection. It can be advantageous toprovide a sterile barrier for non-sterile portions of the central unit400 that may come into contact with the insertion and visualizationdevices. For example, the primary camera 224 can be advanced orretracted by the one or more sterile drivers 232, which can rotate toadvance or retract the camera, as described in more detail in U.S.patent application Ser. No. 16/156,651 filed on Oct. 10, 2018 and Ser.No. 16/156,625 filed on Oct. 10, 2018. As described herein, sterility ofthe looped portion of the primary camera positioned in the slit 504 canbe maintained with a sterile insert (for example, insert 640) positionedin the slit 504. The sterile cover 550 can advantageously maintainsterility of the one or more of insertion or visualization devicesmounted to the one or more pins covered by the cover 550.

FIG. 2B illustrates covering (such as, enclosing) the central unit 400with a sterile barrier 650, which can include a drape 600 and a drapecoupler 610. FIG. 2C illustrates covering (such as, enclosing) a portionor part of the arm 300 with a sterile barrier, such as a sterile drape700. As described herein, the drape 700 can overlap a portion of thedrape 600 of the sterile barrier 650. In some cases, a portion of thedrape 700 can attach, connect or otherwise couple to a portion of thedrape 600 by the use of one or more of any of the fasteners describedherein.

After (or in some cases before) covering the central unit 400 with thesterile drape 600, one or more of the insertion or visualization devices210 and 220 can be attached to the central unit, such as mounted on themounting interface 500. As illustrated in FIG. 2D, the visualizationdevice 220 can be mounted to the mounting interface 500. As shown, thevisualization device 220 can be positioned on the one or more pins 510covered by the one or more drivers 232 and the one or more pins coveredby the cover 500 (such as, the top two pins) to maintain sterility ofthe visualization device (and the primary camera attached to thevisualization device). After (or in some cases before) the visualizationdevice 220 has been mounted to the mounting interface 500, the insertiondevice 210 can be mounted to the mounting interfaces, as illustrated inFIG. 2E. The insertion device 210 can be mounted on the one or more pinscovered by the cover 500 (such as, the bottom two pins).

As shown in FIG. 2F, bottom surface 410 of the central unit 400 caninclude one or more instrument interfaces 420 configured to support andactuate one or more surgical instruments (as illustrated, for example,in FIG. 4E). Each instrument interface 420 can include a plurality ofactuators 422 configured to interface (for example, mate with) with aplurality of actuators of a surgical instrument attached to theinstrument interface (for instance, the actuators 322 of the surgicalinstrument illustrated in FIGS. 4G-4H). For example, the protrusion ofthe actuator 422 can interface with (such as mate with) the opening inan actuator 322 of the surgical instrument (sometimes referred to assurgical instrument actuator). Movement of the actuators 422, such asmovement left and down (or up and down, or otherwise from one point toanother point), can cause corresponding movement of the actuators of thesurgical instrument. This can cause an end effector portion of theinstrument (which can be located at the distal end of the instrument) toarticulate or move (for example, in three dimensions), changeorientation (for example, in three dimensions including rotation),and/or actuate or perform a function (such as, open or close a jaw of agrasper) as needed for performing the medical procedure.

To maintain sterility of the one or more surgical instruments, one ormore sterile interfaces 680 (sometimes referred to as covers,interfaces, shields, or adapters) can be attached to or positioned onthe instrument interfaces 420 that may not be sterile (for example, dueto particular difficulty of sterilizing the plurality of actuators 422).As described herein, one or more sterile adapters 680 can be removablyattached to the instrument interfaces 420, and an instrument can beplaced or positioned in contact with the sterile adapter(s) 680 whenmounted on the instrument interfaces 420. For example, when a singlesterile adapter 680 is used to attach to the instrument interfaces 420,the sterile adapter can be configured to (for example, sized and shaped)to coincide or substantially coincide with the size and shape of theinstrument interfaces 420. Sterile adapter 680 can have the same orsubstantially similar length and width as the instrument interface 420.

With reference to FIGS. 4A and 4D, the sterile adapter 680 can include aplurality of actuator covers 622 corresponding in size and shape to theplurality of actuators 422. The plurality of actuators 422 can becovered by the actuator covers 622 (for example, enclosed by or receivedin the actuator covers 622). Actuators covers 622 are also illustratedin FIG. 8N (which illustrates the adapter 680 in a perspective bottomview).

Although the actuators 422 are illustrated as protrusions (such as, amale connector), in some cases, one or more actuators 422 can include anopening or slot (such as, a female connector) configured to (forexample, sized and shaped) to receive a protrusion of a correspondingsurgical instrument actuator. In such cases, one or more actuator covers622 can be configured to (for example, sized and shaped) to correspondto the size and shape of the actuators 422. Additional details ofmounting and actuating a surgical instrument are disclosed in U.S. Pat.No. 9,629,688, the entire disclosure of which is incorporated byreference and should be considered part of this specification.

FIG. 2G illustrates covering a portion (or entirety) of the column 200with a sterile barrier, illustrated as a drape 800. The drape 800 canfacilitate maintaining sterility of sterile barrier of the central unit400 (such as, the drapes 600 and 700) in case the central unit 400 ismoved to come into contact with the column 200 (or another sterileobject or person comes into contact with the column 200). As describedherein, the drape 800 can be removably attached to the column 200 in oneor more different positions or orientations. This can facilitateprotecting the column 200 from coming into contact with blood, fluids,tissue, or the like during the medical procedure.

Sterile Barrier for Central Unit

FIG. 3A illustrates the sterile barrier 650 for the central unit. Thesterile barrier 650 can include the drape 600 and the drape coupler 610(which can be sometimes be referred to as tray). Both the drape 600 andthe drape coupler 610 can be sterile. As described herein, the drapecoupler 610 can be removably attached to at least one surface, forexample the bottom surface 410, of the central unit 400. The drapecoupler 610 can be configured to (for example, sized and shaped) tomatch the size and shape of the bottom surface 410 of the central unit400. The drape coupler 610 can be rigid or substantially rigid. Thedrape coupler 610 can include one or more rigid or substantially rigidmaterials, such as plastic, metal, or the like.

The drape 600 can be flexible or substantially flexible. The drape caninclude one or more flexible or substantially flexible materials, suchas polyethylene (PE) (for example, low density polyethylene),polyurethane (PU), polyvinyl chloride (PVC), or the like. Although shownas separate components in FIG. 3A, the drape coupler 610 and the drape600 can be attached to, or otherwise integrated with, each other. Forexample, the drape 600 can be attached to the drape coupler 610 along aperimeter of the drape coupler. With reference to FIG. 3B, in somecases, the drape 600 can be attached along a perimeter outlined by 612.For instance, the drape 600 can be adhered to portions of the drapecoupler 610 that are positioned between the edges and the perimeteroutlined by 612. The drape coupler 610 can facilitate covering (forinstance, enclosing) the central unit 400 with the drape 600 due to, forexample, preventing the drape (which can be flexible) from collapsing,keeping the drape in a position around the perimeter of the centralunit, or the like (see, for example, FIGS. 8B and 8C).

The cover 550 illustrated in FIG. 3A can be integrated into the sterilebarrier 650. For example, the cover 550 can be attached to the drape600, such as in the region 606 (see also FIG. 3D). For instance, thecover 550 can be attached through the openings or holes illustrated inthe region 606 (such as, four holes). This is shown in FIGS. 3E-3F,which illustrate the sterile barrier 650 in a perspective front view andperspective bottom view, respectively. The attachment can be byadhesive, heat sealing, or the like.

An insert 640 (which can be sometimes be referred to as shell) can bepositioned in the slit 504 of the central unit 400. The insert 640 canbe have concave shape matching in size and shape the slit 504. Theinsert 640 can have side surfaces connected at one end (such as, at thebottom) and not connected at the opposite end (such as, at the top) toform an opening. As described herein, the looped portion of the primarycamera tube 225 can be positioned in the slit 504. The slit 504 can becovered by the insert 640, and the looped portion of the primary cameratube 225 can be positioned in the insert 640. The insert 640 can berigid or substantially rigid, which can facilitate the insert remaininginside the slit 504. The insert can include one or more materials thatare more rigid than the one or more materials of the drape. For example,the insert 640 can include one or more of plastic materials, such ashigh-density polyethylene (HDPE), acrylonitrile butadiene styrene (ABS),metal, or the like.

The insert 640 can be integrated into the sterile barrier 650. Forexample, as illustrated in FIGS. 3E-3F, the insert 640 can be attachedto the drape 600, such as in the region 604 (see also FIG. 3D). Theattachment can be by adhesive, heat sealing, or the like.

The cover 550 can include one or more rigid or substantially rigidmaterials, such as any of the materials described herein. For example,the cover 550 can include one or more plastic materials. The one or morematerials of the cover 550 can be more rigid than the one or morematerials of the insert 640. This can be due to the cover 550 providingsupport for the insertion device 210 and/or visualization device 220,and the insert 640 being substantially flexible to facilitate insertioninto the slit 504.

FIG. 3B illustrates the drape coupler 610 as viewed from the side thatis configured to face the bottom surface 410 of the central unit 400(for example, inner facing side or upper surface of the tray illustratedin FIG. 3A). The drape coupler 610 can include one or more attachmentsor fasteners 614 configured to facilitate mounting of the drape coupler610 to the bottom surface 410 of the central unit 400. The drape coupler610 can be removably mounted to the bottom surface 410. In some cases,the fasteners 614 can include metal (or another ferromagnetic material)for attachment to the one or more attachments or fasteners positioned onthe bottom surface 410 (which can be similar to one or more of fastenersillustrated in FIGS. 1B-1C). For instance, the fasteners 614 can bemetal washers, and the one or more fasteners positioned on the bottomsurface 410 can include magnetic material. The bottom surface 410 caninclude the same number of fasteners as on the drape coupler 610 (forexample, four) to help facilitate the correct alignment between thedrape coupler and the bottom surface of the central unit 400.

Instrument interfaces 420 of the central unit 400 (and attached surgicalinstrument(s)) can be configured to move (such as, linearly) toward andaway from the site of interest (such as, the surgical site). Forexample, after a surgical instrument is mounted to the respectiveinstrument interface 420 (using, for instance, a sterile adapter 680),the instrument may need to be advanced forward into the surgical site.To accomplish such movement, the instrument interface 420 can slideforward along one or more grooves on the bottom surface 410 (see, forexample, FIG. 2F), which can cause the surgical instrument tocorrespondingly advance forward. When the surgical instrument may needto be repositioned or removed, the surgical instrument may need to beretracted away from the surgical site. To accomplish such movement, theinstrument interface 420 can slide backward along the one or more groves(such as, into position illustrated, for example, in FIG. 2F), which cancause the surgical instrument to correspondingly retract away from thesurgical site.

As shown in FIG. 3B, the drape coupler 610 can include one or moreopenings (sometimes referred to as windows) to expose the one or moreinstrument interfaces 420 of the central unit 400. The openings, whichare also illustrated as 624A and 624B in FIG. 3C, can be moveable tofacilitate movement of the one or more instrument interfaces 420 asdescribed herein. To maintain sterility of the one or more surgicalinstruments (such as, preventing any part of a surgical instrument fromcoming into contact with the non-sterile bottom surface 410 of thecentral unit 400), the openings can include fixtures or frames 616A and616B, which can slide forward and backward within slots or grooves ofthe drape coupler 610. The frames 616A and 616B can be rigid orsubstantially rigid. The frames can include rigid or substantially rigidmaterial, which can include any one or more of rigid or substantiallyrigid materials described herein. The groves for facilitating movementof the frames 616A and 616B can be formed, for example, by a structure608 (illustrated in FIG. 3C as a frame) positioned on the opposite sideof the drape coupler 610 than that in FIG. 3B. The frame 608 can includeany one or more of rigid or substantially rigid materials describedherein. The groves can be formed between the frame 608 and another framepositioned on the inner facing side of the tray 610 shown in FIG. 3B.Another frame can be rigid (for instance, include any one or more ofrigid or substantially rigid materials described herein).

One or more of the windows (624A and 624B) or the frames (616A and 616B)can be configured to (for example, sized and shaped) to match the sizeand shape of the instrument interfaces 420. The windows can have thesame of substantially similar length and width as the correspondinginstrument interfaces 420.

The frames 616A and 616B can be attached to or connected to one or moreflexible or substantially flexible regions or sections 620A and 620B,which can include any of the flexible or substantially flexiblematerials described herein. The flexible sections can collapse and/orexpand when the openings are moved, for example, forward and/orbackward. This can facilitate maintenance of the sterile barrier betweenthe central unit 400 (such as, its bottom surface 410) and one or moresurgical instruments. As illustrated in FIG. 3C, similar flexiblesections (such as, section 621B) can be positioned and connected to thetop of the frames 616A and 616B. In FIG. 3B, bottom flexible sections620A and 620B are shown in an expanded position or configuration (suchas, fully expanded configuration), while top sections are shown in acollapsed position or configuration (such as, fully collapsedconfiguration). Location (or position) of the openings shown in FIG. 3Bcan correspond to a default location for mounting the drape coupler 610to the bottom surface 410 of the central unit 400. This location cancorrespond to default (or docked) position or location of the instrumentinterfaces 420 (such as, when the robotic surgery system is beingprepared for the medical procedure). The openings, which are moveable,can be maintained in the default location by one or more removablefasteners attached, for example, to edges of the frames 616A and 616Band one or more surrounding surfaces of the drape coupler 610. Forinstance, adhesive tear tabs can be used as fasteners.

Bottom flexible sections 620A and 620B (and similar top sections) caninclude one or more dividers or inserts 618A and 618B, as shown. Suchinserts can be rigid or substantially rigid. The inserts can include oneor more materials that are more rigid than the one or more materials ofthe sections 620A and 620B, such as any of the rigid or substantiallyrigid materials described herein. The inserts 618A and 618B canfacilitate expansion and collapse of the flexible sections 620A and620B, respectively. The inserts 618A and 618B can be configured to allowone or more flexible portions of the sections 620A and 620B,respectively, to wrap around, fold or be received overlapping arespective section, when the sections 620A and 620B are being collapsed.One or more flexible portions of the sections 620A and 620B can wraparound or fold onto the respective insert 618A and 618B. As illustratedin FIG. 3C, the insert 618A can be tapered. For example, the insert 618Ainclude one or more tapered sides or edges 623A. The insert 619B can betapered. For example, the insert 619B can include one or more taperedsides or edges 625B. The sides or edges can be tapered toward the one ormore flexible portions of the respective section 620A and 620B. Taperedshape of the one or more inserts 618A and 619B can facilitate wrappingor folding of the flexible material of the sections 620A and 620B,respectively, or facilitate respective sections overlapping one another,as the sections are being collapsed. For instance, tapered shaped canfacilitate the flexible material edges to be lifted (or scooped up) andfolded as the one or more sections 620A and 620B are being collapsed.

FIG. 3C illustrates the tray 610 viewed from the side opposite than thatshown in FIG. 3B, such as from the outer facing side (or surface) of thetray. In FIG. 3C, the left opening 624A is illustrated in the samelocation as in FIG. 3B, while the right opening 624B is illustrated in adifferent location. The right opening 624B is illustrated as being moveddown (which can correspond to forward movement of the right instrumentinterface 420 and mounted surgical instrument, causing the surgicalinstrument to move towards the site of interest). Bottom flexiblesection 620B on the right is illustrated in the collapsed configuration(such as, fully collapsed configuration). Top flexible section 621B isillustrated in the expanded configuration (such as, fully expandedconfiguration). The flexible section 621B can include an insert 619B,which can be similar to the inserts 618A and 618B described herein. Aflexible section similar to 621B can be positioned adjacent to topportion of the left window 624A. This flexible section is shown in thecollapsed configuration (such as, fully collapsed configuration).

In some cases, when a particular flexible section is in a fullycollapsed configuration, the opening is positioned at a maximum distancein which it is configured to move in that direction. For example, FIG.3B illustrates the openings retracted to a maximum distance. As anotherexample, FIG. 3C illustrates the opening 624B moved forward to a maximumdistance. The maximum distances associated with movement of the openings624A and 624B can correspond to range of movement of the instrumentinterfaces 420.

Although the illustrated central unit 400 and sterile barrier 650 areconfigured to facilitate attachment of two surgical instruments to thecentral unit, the central unit 400 and sterile barrier 650 can beconfigured to facilitate attachment of a single surgical instrument ormore than two surgical instruments.

Any of the one or more windows (624A and 624B) can be covered by a cover(sometimes referred to as protector). The protector can be removable.For example, the protector can be attached or affixed to a bottomsurface of the drape coupler 610 (see FIG. 3F). With reference to FIG.3A, the protector 655 can be attached as shown. The protector 655 cancover the entire (or substantially entire) bottom surface of the drapecoupler 610 or a portion of the surface. The protector can be attached,for instance, with adhesive. In some cases, the protector can includeone or more sections that are independently removable. For example, theprotector can include two sections covering the windows 624A and 624B.

FIG. 3D illustrates the drape 600 in an unfolded configuration. Thedrape 600 is illustrated as being detached from the drape coupler 610.As described herein, the drape 600 can be attached to the drape coupler610, and in folded configuration to form an enclosure configured (forexample, sized and shaped) to enclose the central unit 400 (see, forexample, FIG. 3A). One or more dimension of the drape 600 can correspondto (or be greater than) the one or more dimensions of the central unit400.

The drape 600 can include one or more compartments (sometimes referredto as a pouches or pockets) illustrated as 672, 674, 676, and 678. Anouter surface of the drape 600 (sometimes referred to as an outer side,outer facing surface, or outer facing side) can be configured to remainsterile during the medical procedure. The opposite inner side of thedrape 600 (sometimes referred to as an inner side, inner facing surface,or inner facing side) can come into contact with one or more non-sterilesurfaces of the central unit 400, and therefore may not remain sterile(even though the entire sterile barrier 650 may be sterile whenpackaged). The pockets can help maintain sterility of the outer surfaceof the drape 600 when a user, such as sterile nurse (for example, scrubnurse), covers the central unit 400 with the drape 600. For example, thepockets can prevent the user's hand from touching any non-sterilesurface when the drape is being attached or affixed to the central unit400. Any of the pockets described herein can facilitate maintainingsterility of a sterile barrier being attached to cover a component ofthe robotic surgery system.

Any of the pockets can be configured (such as, sized and shaped) to atleast partially enclose the user's hand or part of the user's hand (suchas, a finger or multiple fingers). One or more of the pockets 672, 674,676, and 678 can be positioned on an outer surface of the drape 600 (or,in some cases, on the inner facing surface of the drape). Any of thepockets described herein can be formed by attaching a flexible orsubstantially flexible material to the drape, such as by heat sealing,adhering, or the like, or by causing a portion of the drape material tobe folded and then heat sealing certain portions to form one or morepockets, with regions of the folded drape not requiring a pocket orenclosure being optionally removed. The material attached to the drapecan be the same or similar to the one or more materials of the drape,which can be any of the flexible materials described herein. One or moreof the pockets 672, 674, 676, and 678 can be configured to enclose auser's hand.

The pockets can be labeled, for example, with labels 666, 667, 668, and669, respectively. Any of the labels can include an indication (orindicia) of which hand (left or right) or portion of the hand should beinserted into the pocket. For example, as illustrated in FIG. 7B, label910 can guide the user to insert the right hand into the pocket andlabel 912 can guide the user to insert the left hand into the pocket.The hand shape in label 910 corresponds to the shape of the right hand(with the thumb being on the left side when palm of the right hand facesthe page). The hand shape in label 912 corresponds to the shape of theleft hand (with the thumb being on the right side when palm of the lefthand faces the page). Any of the labels can additionally oralternatively guide the user in which direction to insert a particularhand. With reference to FIG. 7B, label 912 can guide the user to insertthe right hand with the palm facing the central unit 400, as thisorientation of the right hand would match the outline of the right handdepicted in the label (such as, when the label is attached to theinterior front or rear surface of the pocket, which can be positioned onthe outer facing surface of the drape). Similarly, label 912 can guidethe user to insert the left hand with the palm facing the central unit400, as this orientation of the left hand would match the outline of theleft hand depicted in the label (such as, when the label is attached tothe rear surface of the pocket). Any of the labels described herein canbe attached to the interior or exterior surfaces of the pocket and/orother surfaces of the drape.

In some cases, labels 666 and 667 can guide the user to insert the righthand, and labels 668 and 669 can guide the user to insert the left hand.The pockets can be paired depending on a step of the process forcovering the central unit 400 with the drape 600. When two pockets arepaired, the user may insert right and left hands into respective pocketsof the pair to perform the particular step. The labels can provideindication of the pairing. For example, as illustrated in FIG. 7C,labels 920 (right hand) and 922 (left hand) include the number “1”indicating pairing of the two labels. Indication of the pairing may alsocorrespond to the order of the process. For example, the number “1” canindicate an earlier (such as, first step) in the process than one ormore labels with subsequent numbers, such as “2,” “3,” or the like. Insome cases, letters, images, or the like can be used instead of or inaddition to the numbers.

The drape 600 can include one or more attachments or fasteners 652 and662. Fastener 652 can be positioned in a region of the drape covered by(or overlaps with) the pocket 672. Fastener 662 can be positioned in aregion of the drape covered by the pocket 678. As described herein, oneor more of the fasteners 652 and 662 can include ferromagnetic material,such as a metal washer, configured to be attached to an attachment orfastener of the central unit, such as one or more of fasteners 302 and304 (for example, by being brought into contact or into proximity of theone or more fasteners 302 and 304). Any of the fasteners 652 and 662 canbe positioned on or adjacent to the inner facing surface of the drape600, which is configured to come into contact with the central unit 400.

In some cases, pockets 672 and 678 can be paired. For example, labels666 and 669 associated with the pockets 652 and 662, respectively, cancorrespond to labels 920 and 922 illustrated in FIG. 7C. As shown inFIGS. 8B-8D, the user can be guided to insert the right hand into thepocket 672 and left hand into the pocket 678 (or vice versa). The drape600 can subsequently be lifted and attached to the central unit 400 (forexample, by forming a magnetic attachment between the fasteners 652 and662 and fasteners 302 and 304). The pockets 672 and 678 can facilitatemaintaining sterility of the outer facing surface of the drape 600 whenthe drape is being attached to the central unit 400. When the drape 600is in the folded configuration as illustrated in FIG. 3A, the pockets672 and 678 can be positioned adjacent to each other (see, for example,FIGS. 8B-8D).

The drape 600 can include attachments or fasteners 654, 656, 658, and660, which may not be attached to the central unit 400. The drape caninclude fasteners similar to the fasteners 654, 656, 658, and 660positioned in the same or similar region as the previously describedfasteners 652 and 662 (which, as described herein, can be attached tofasteners of the central unit 400). For example, the fasteners 652 and662 can be positioned on or adjacent to the inner facing surface of thedrape, while the other fasteners can be positioned on or adjacent to theopposite exterior facing surface of the drape (such as, on an exteriorsurface of the pockets 672 and 678). Because regions illustrated as 652and 662 can include multiple fasteners, for simplicity, the fastenerspositioned in the same or similar region as the previously describedfasteners 652 and 662 can be referred to as second fasteners 652 and662. Fasteners 654, 656, 658, and 660 as well as the second fasteners652 and 662 can facilitate covering (such as, enclosing) the centralunit with the drape 600 and maintaining the drape in the desiredposition during the medical procedure. These fasteners can be attached(or connected) to one another as described herein. Any of thesefasteners can provide removable attachment and can include one or moreof a hook-and-loop fastener (for example, a VELCRO® Brand fastener),adhesive fastener, button fastener, magnetic fastener, zippers, or thelike.

Second fasteners 652 and 662 can be positioned in regions of the drapecovered by pockets 672 and 678, respectively. As described herein,second fasteners 652 and 662 can be paired (or configured for beingattached to), for instance, to fasteners 656 and 658, respectively.Second fasteners 652 and 662 can be removably attached of affixed tofasteners 656 and 658, respectively. In some cases, second fasteners 652and 662 can be VELCRO fasteners.

In some cases, pockets 674 and 676 can be paired. For example, labels668 and 667 associated with the pockets 674 and 676, respectively, cancorrespond to labels 922 and 920 illustrated in FIG. 7C (with theexception of replacing the number “1” in both labels with, for instance,the number “2” indicating a step subsequent to that indicated by thenumber “1”). The user can be guided to insert the right hand into thepocket 676 and left hand into the pocket 674 (or vice versa). Fastener656 can be positioned in a region of the drape 600 covered by the pocket674. Fastener 658 can be positioned in a region of the drape 600 coveredby the pocket 676. Fastener 656 can be paired with or connected to thesecond fastener 652. Fastener 658 can be paired with or connected to thesecond fastener 662. As illustrated in FIGS. 8E-8F, fastener 656 can beremovably attached to the second fastener 652, and fastener 658 can beattached to the second fastener 662. In some cases, fasteners 656 and658 can be VELCRO fasteners. The pockets 674 and 676 can facilitatemaintaining sterility of the outer facing surface of the drape 600 whenthe user is attaching the fasteners 656 and 658 to the second fasteners652 and 662, respectively. As illustrated in FIG. 3A, the pockets 674and 676 can be positioned adjacent to each other (see also, for example,FIGS. 8E-8F). The pockets 674 and 676 can be positioned opposite thepockets 672 and 678 when the drape 600 is in the folded configuration(see, for example, FIGS. 8B-8F).

The drape 600 can include fasteners 654 and 660. These fasteners can bepaired. The fasteners 654 and 660 can be attached to each other (forexample, removably attached) as illustrated in FIG. 8G. In some cases,fasteners 654 and 660 can be VELCRO fasteners. Fasteners 654 and 660 canbe connected to each other to tighten the drape 600 around the centralunit 400, as illustrated in FIG. 8G. For instance, fasteners 654 and 660can be positioned in a portion of the drape 600 configured to cover arear portion of the central unit 400. One or more pockets may not beneeded to attach the fasteners 654 and 660, for example, due to a low ornon-existent risk of the user touching, or otherwise coming into contactwith, any non-sterile surface of the central unit 400. For instance,there may be folds on the outer facing surface of the drape where thefasteners 654 and 660 are positioned. The user can grab or pinch thefolds to connect the fasteners 654 and 660 without the risk of touchingany non-sterile surfaces of the central unit 400.

In FIG. 3D, all pockets and fasteners are illustrated as beingpositioned near the top edge of the drape. This positioning may beappropriate because the bottom side of the drape 600 can be attached tothe drape coupler 610. As described herein, the drape coupler can beattached to the bottom surface 410 of the central unit 400, which mayobviate the need to separately attach the bottom portion of the drape600 to the central unit 400 (and thus include one or more pockets orfasteners). In some cases, any of the pockets, fasteners, or labels canbe positioned in a different location (including on a different surface)or removed. Additional pockets, fasteners, or labels fasteners can beadded.

Sterile Adapter for Surgical Instrument Interface

FIGS. 4A-4D illustrate the sterile adapter 680 in a front perspectiveview, side view, rear view, and top prospective view, respectively. Thesterile adapter 680 (or multiple sterile adapters as shown in FIG. 2F)can be part of the sterile barrier 650 for the central unit 400. Theadapter 680 can be attached to the instrument interface 420 and providea sterile barrier between the instrument interface and a surgicalinstrument. The illustrated adapter 680 can be a sterile barrier for aleft (see “L” on the front of the adapter as shown at 683) instrumentinterface 420 of the central unit 400 (see, for example, FIGS. 3B-3C).The right instrument interface 420 can be covered with a similar sterileadapter.

The adapter 680 can include a housing configured to support the surgicalinstrument (see, for example, FIGS. 4G-4H). The adapter 680 can beremovably attached to the instrument interface. As is illustrated inFIG. 4A, a closure 690 can be configured to attach the adapter 680 (suchas, the front portion of the adapter) to the instrument interface 420.As illustrated in FIG. 4D, the closure 690 can include a releasemechanism (for example, a handle) 692. With reference to FIG. 8L, theclosure 690 can be releasably attached to (or mate with) an opening 428of the instrument interface 420. As shown in FIGS. 4B-4C and 8L, theclosure 690 can include a protrusion or latch 691 configured (such as,sized and shaped) to be inserted into the opening 428 when the adapter680 is being attached to the instrument interface 420. The latch 691 canbe positioned on the back of the closure 690 (such as, on the back of oradjacent to the handle 692). The handle 692 can be moved or flexed torelease the latch 691, which can cause disengagement of the latch 691from the opening 428 in the instrument interface 420. For example, theuser can pull on the handle 692 to release the adapter 680. In somecases, the user can push the handle 692 to release the adapter 680.

The latch 691 can include a plurality of latches. Such latches can beshorter and may not extend along the entire length of the closure 690(see FIG. 4C). For example, two latches can be positioned on oppositesides of the closure 690. As another example, three latches can bepositioned as follows: two on the opposite sides of the closure 690 andone in the middle of the closure 690. In some cases, there can be othercombination and/or positioning of the latches.

As illustrated in FIGS. 4B-4D, the adapter 680 can include one or moreprotrusions 682 (sometimes referred to as tabs or hooks) positioned onthe opposite side (such as, a rear side) of the adapter 680 from theclosure 690. The protrusions 682 can be configured to attach (such as,removably attach) the rear portion of the adapter 680 to the instrumentinterface 420. With reference to FIGS. 8K-8L, the protrusions 682 can beconnected to the holes or openings 426 positioned in the rear portion ofthe instrument interface 420 (such as, in the direction illustrated bythe arrows in FIG. 8K). The protrusions 682 can be shaped as hooksconfigured to attach to corresponding openings 426, as shown by thearrows in FIG. 8K. The protrusions 682 can make contact with (such as,hook onto) the surface of the openings 426 (such as, edges of theopenings). Such attachment can be removable as the moving the adapter680 down (such as, at an angle) can release the back portion of theadapter. FIG. 8M illustrates the adapter 680 affixed or attached to theinstrument interface 420.

With reference to FIGS. 4D and 8K-8M, one or more protrusions or plates689 on the sides of the adapter 680 can facilitate one or more ofattachment to, removal from, and support of the adapter by theinstrument interface 420. The plates 689 can contact side portions ofthe instrument interface 420 as illustrated in FIG. 8M.

As described herein, the adapter 680 can include a plurality of actuatorcovers 622 (see, for example, FIG. 4D) configured to receive a pluralityof actuators 422 of the central unit 400. The actuator covers 622 canprovide a sterile interface between the actuators 422 of the instrumentinterface 420 and the actuators of the surgical instrument, such asactuators 322 of a surgical instrument, such as the instrument 364illustrated in FIG. 4F. Movement of the actuators 422 can be transferredthrough the actuator covers 622, which can be configured to move withthe actuators 422 (for instance, left and right), to the actuators 322of the surgical instrument. This can cause the end effector portion ofthe instrument, such as the end effector 366 of the instrument 364illustrated in FIG. 4F, to articulate or move.

It may be advantageous to facilitate removal of the surgicalinstrument(s) 364 from the site of interest in case of malfunction ofthe robotic surgery system (or any of its components), loss of power,emergency, or the like. The actuator covers 622 are illustrated in FIGS.4A-4D as being positioned or aligned (such as, centrally aligned), whichcan correspond to the default position or alignment of the actuators 422(such as, for loading the surgical instrument; see, for example, FIG.8L). During the performing of the medical procedure, the actuators 422(and actuator covers 622), which can be configured to move independentlyof one another, may no longer be in the default (aligned) position dueto manipulation of the end effector portion of the surgical instrument.Because of the misalignment, it may not be possible to remove thesurgical instrument by simply pulling out the instrument from thesterile adapter 680. The sterile adapter 680 can be configured to allowthe surgical instrument to be removed when the robotic surgery system isin use by rotating the surgical instrument to disengage the actuators322 of the surgical instrument from the actuators 422 covered by theactuator covers 622. Such design can promote safety, simplicity, andefficiency, among other advantages.

With reference to FIGS. 4A and 4B, the adapter 680 can include a grooveor guide 684 (sometimes referred to as a slot) configured (such as,sized and shaped) to receive a housing of a surgical instrument (see,for example, FIGS. 4F-4H). The guide 684 can be of a width 686 thatmatches the width of the surgical instrument housing (for example,housing 365, which is shaped as a rectangular cassette, as shown inFIGS. 4F-4H). The guide 684 can facilitate loading (or removal) of thesurgical instrument housing. The guide 684 can include a protrusion 687(such as, a rib or rail) configured (such as, sized and shaped) to guidethe surgical instrument housing into the adapter 680. The surgicalinstrument housing can include an opening or groove, such as, the groove370 illustrated in FIG. 4G, configured to receive the protrusion. Thegroove can be positioned on the side of the housing of the surgicalinstrument (such as, the left side for the left instrument, asillustrated in FIG. 4F).

The guide 684 can be configured to guide the surgical instrument housinginto the adapter 680. As illustrated in FIG. 4A, the guide 684 can beoriented at an angle relative to the horizontal plane, in which theactuators 422 and actuator covers 622 can be oriented. The plane of theguide 684 can be tilted relative to the plane of the actuator covers622. This can facilitate loading (or removing) the surgical instrumenthousing at an angle. The angle can be 5 degrees (or less or more), 8degrees, 10 degrees (or less or more), 12 degrees (or less or more), 15degrees (or less or more), 20 degrees (or less or more), or the like.The angle can be less than 5 degrees or more than 20 degrees. When thesurgical instrument is loaded through the guide 684, the surgicalinstrument actuators 322 may not be engaged with (or coupled to) theactuators 422 covered by the actuators covers 622.

The surgical instrument housing 365 may be rotated inside the adapter680 in order to facilitate engagement of surgical instrument actuators322 with the actuators 422 (covered by the actuator covers 622). Asillustrated in FIGS. 4A-4B, a fastener 694 (sometimes referred to as acatch) can be configured to one or more of support the housing of thesurgical instrument housing and to rotate the housing within the adapter680. The fastener 694 can include a protrusion 695 (sometimes referredto as rib or rail) configured (such as, sized and shaped) to engage withthe surgical instrument housing. For example, the rail 695 of thefastener 694 can engage with an opening or groove positioned on the sideof the surgical instrument housing 365 (such as, the groove 370illustrated in FIG. 4F). The rail 687 of the guide 684 and the rail 695of the fastener 694 can be level or substantially level (see, forexample, FIG. 4B), and the groove can be the same groove as describedherein in connection with the rail 687.

The fastener 694 can include (such as, be connected to) a handle orlever 696. The user can move the lever in one or more directions, suchas up and down. When the lever 696 is moved upward (for example, due tothe user pushing the lever up), the fastener 694 and the rail 695 canmove upward. This can cause the surgical instrument housing to rotate.For instance, the rotation can be due to the rail 695 being moved up andcausing the side of the instrument on which the groove 370 is positionedto move up. In some cases, the lever 696 can be pulled down and/or toone of the sides to cause rotation of the surgical instrument housing365.

With reference to FIG. 4G, the surgical instrument housing 365 isillustrated as being positioned in the adapter 680, which is shownpositioned upside down. Unlike normal operation, the surgical instrumenthousing 365 is positioned upside down in the adapter to illustrate theactuators 322. The user can move the lever 696 down (or upward when theadapter 680 is correctly positioned), as illustrated by the arrow 442.This can cause the surgical instrument housing 365 to be rotated in thedirection of the arrows 444. The rotation can be in clockwise direction.In some cases, the rotation can be in counterclockwise direction.Position of the rotated surgical instrument housing 365 is illustratedin FIG. 4H (which also shows the adapter and surgical instrument housingupside down).

The lever 696 can be locked into position so that the surgicalinstrument housing 365 remains in the rotated position, in which thesurgical instrument actuators 322 are engaged with the actuators 422(covered by the actuator covers 622). The lever can be locked intoposition (or unlocked during removal of the surgical instrument) bylocking (or unlocking) a closure of the lever, such as a latch. The usercan lock the lever 696 into position by, for instance, moving the lever696 outward (or in a direction away from the adapter 680). Unlocking thelever 696 can be performed by moving the lever in the oppositedirection.

With reference to FIG. 4E, central unit 400 is shown in a rear view withsurgical instruments 364 attached to the instrument interfaces 420 (orloaded). With reference to FIG. 4F, the instrument 364 can include thesurgical instrument housing 365, a shaft 368 connected to the housing,and an end effector 366 connected to the shaft. As illustrated in FIG.4E, the shaft 368 and the end effector 366 can be loaded through anopening 340 formed in the rear of the housing 212 of the insertiondevice 210. The surgical instrument housing 365 can be rotated (orpivoted) about an axis 440 that traverses along a center of the shaft ofthe surgical instrument. The axis 440 can coincide with the axis thattraverses along a center of the end effector 366. The surgicalinstrument housing 365 can be rotated about the axis that traversesalong the center of the end effector 366. The axis 440 can coincide withthe axis that traverses along a center of the opening 340 in theinsertion device 210 through which the end effector and the shaft of thesurgical instrument are inserted during loading. The surgical instrumenthousing 365 can be rotated about the axis that traverses along (orthrough) the center of the opening 340.

To load the surgical instrument 364, the user can move the surgicalinstrument housing 365 through the guide 684 (at an angle, as describedherein). With reference to FIGS. 4B and 4F, the length 685 of the guide684 can be shorter than the length of the surgical instrument housing365. Once a portion (or entirety) of the surgical instrument housing 365passes through the guide 684, it can engage with the rail 695, asdescribed herein. In some cases, the surgical instrument housing 365 canengage with the slot 688 positioned at the top of the adapter 680, asshown in FIG. 4A. The surgical instrument housing 365 can be supportedby one or more of the rail 695 or the slot 688. In some cases, asillustrated, the adapter 680 does not include a bottom. With referenceto FIGS. 4B and 4F, the length 685 of the portion of the adapter that isadjacent to the guide 695 can be sufficient to receive the entiresurgical instrument housing 365. The length 681 of the portion can matchthe length of the surgical instrument housing 365, such as be the same,substantially the same, or larger than the length of the surgicalinstrument housing. Once loaded, the surgical instrument housing 365 canbe rotated (and, optionally, locked) into position, in which thesurgical instrument actuators 322 are engaged with the actuators 422(covered by the actuator covers 622).

As illustrated in FIGS. 4A-4D, the guide 684 can be positioned on or ina first side portion of the housing of the adapter 680. The fastener 694(and the rail 695) can be positioned on or in a second side portion ofthe housing of the adapter 680. The first and second side portions canbe positioned on the same side of the housing (for example, left side incase of an adapter for the left instrument). The first and second sideportions may not be connected. For example, the first and second sideportions can be separated by a gap as shown in FIG. 4B. In some cases,the guide 684 and fastener 694 can be positioned in the same sideportion.

In some cases, any of the actuators 422 can be tapered as illustrated inFIGS. 8K-8L. The base (or proximal portion) of the respective actuator422 can be wider than the end (or distal portion) of the actuator. Anyof the actuator covers 622 can be similarly tapered. The tapered shapecan facilitate engagement with the surgical instrument actuators 322 asthe surgical instrument housing is being rotated.

To remove the instrument 364, the user can perform steps opposite tothose performed during the unloading of the instrument. For example, thelever 696 can be unlocked. The latch can be unlocked (such as, by movingthe lever 696 inward). This can cause the fastener 694 and the rail 695to move downward, which causes the surgical instrument housing 365 torotate. The surgical instrument actuators 322 can be disengaged from theactuators 422 (covered by the actuator covers 622). The instrument canbe removed from the adapter 680.

The fastener 694 can include an elastic element, such as a spring. Forexample, the rail 695 can be biased by the elastic material or elementinto a position in which the surgical instrument housing 365 is notrotated (such as, downward position). To rotate the surgical instrumenthousing 365, the user can move the lever 696 upward, which can causecompression of the elastic material. When the user releases the lever696, the elastic material can decompress causing the rail 695 to bemoved downward. This can facilitate easier removal of the surgicalinstrument.

With reference to FIG. 4I, an adapter 680′ is illustrated. The adapter680′ can be similar to the adapter 680 (and vice versa). The adapter680′ can include a plurality of rail sections 695′ (for example, two asshown), which can operate similarly to the rail 695. In some cases, morethan two rail sections 695′ can be included. The rail sections 695′ canbe separated by one or more gaps. Lever 696′ can operate similarly tothe rail 696. Rail 696′ can be shorter than the lever 696. The lever696′ can be integrated into a side of the housing of the adapter 680′.

With reference to FIG. 4J, a combination 1300 of an adapter 1315 withthe surgical instrument housing 365 is illustrated. The adapter 1315 canbe similar to the adapter 680 (and vice versa). A cover 1302 can bepositioned on the surgical instrument housing 365. The cover 1302 can beconnected to the surgical instrument housing 365 (for example, removablyconnected). The cover 1302 can include one or more protrusions 1304(sometime referred to as teeth). Housing of the adapter 1315 can includeone or more openings 1306 configured to receive the protrusions 1304 ofthe cover 1302. When the surgical instrument housing 365 is rotated, theprotrusions 1304 can engage with the openings 1306. This can maintainthe surgical instrument housing 365 in the rotated position. Thesurgical instrument housing 365 can be rotated manually by the user (forexample, moved downward or upward).

A release mechanism 1312 can positioned on or in the housing of theadapter 1315. The release mechanism 1312 can be a latch, such as a latchwith an elastic material (for example, a spring). The release mechanism1312 can be operated by the user (for example, moved to the right orleft) to release the engagement of the protrusions 1304 with theopenings 1306. This can cause the surgical instrument housing 365 to bereleased. The release mechanism 1312 can control one or more releases1308 positioned in the housing of the adapter 1315. Each of the releases1308 can release engagement of a corresponding pair of protrusion 1304and openings 1306. For example, the releases 1308 can be moved upward topush the protrusions 1304 upward and disengage the protrusions 1306 fromthe openings 1306.

With reference to FIG. 4K, a cover 1302′ can include a release mechanism1332. The cover 1302′ can be similar to the cover 1302 (and vice versa).The release mechanism 1332 can be a latch, such as a latch with anelastic material (for example, a spring). The release mechanism 1332 canoperate similarly to the release mechanism 1312. The adapter 1315′ canbe similar to the adapter 1315 (and vice versa). The adapter 1315′ maynot include one or more of the release mechanisms 1312 and/or thereleases 1308.

With reference to FIGS. 4L-4O, an adapter 1340 can include a support orholder 1342 configured to support the surgical instrument housing 365.The holder 1342 can support a bottom of the surgical instrument 364. Theholder 1342 can be similar to any of the covers 1302 or 1302′, but canbe integrated with the adapter 1340. The holder 1342 can be rotated tocause the surgical instrument 364 to rotate. For example, the holder1342 can be rotated counterclockwise. The holder 1342 can operate as alever or a lever arm. A release mechanism 1352 can be operated by theuser (for example, moved to the right or left) to cause the holder 1342to rotate (for example, in the opposite direction, such as clockwise)and the surgical instrument housing 365 to be released. The releasemechanism 1352 can be a latch, such as a latch with an elastic material(for example, a spring). The holder 1342 can be rotated manually by theuser or by operating the release mechanism 1352 as described herein.

In some cases, a shaft of the surgical instrument, such as the shaft368, can be flexible or substantially flexible. The surgical instrumenthousing can be rotated by flexing the shaft of the instrument. Forexample, with reference to FIG. 4E, the shaft 368 can be loaded into theinstrument channel through the opening 340. The surgical instrumenthousing 365 can be rotated by flexing the shaft 368 to facilitateengagement of surgical instrument actuators 322 with the actuators 422(covered by the actuator covers 622).

In some cases, any of the instrument channels can be wider at the endcloser to the central unit 400, such as the end proximal to the opening340. This can allow the shaft 368 to be moved within the instrumentchannel. The surgical instrument can be loaded at an angle and rotatedto facilitate engagement of surgical instrument actuators 322 with theactuators 422 (covered by the actuator covers 622). The shaft can bemoved through the wider part of the instrument channel to facilitate therotation.

In some cases, in addition to or instead of rotation, any of theadapters described herein can be configured to facilitate any movementor transition of a surgical instrument from a first position ororientation in which the surgical instrument actuators 322 aredisengaged from the actuators 422 (covered by the actuator covers 622)to a second position or orientation in which the instrument actuators322 are engaged with the actuators 422. The surgical instrument can beloaded and unloaded by being moved forward and backward in or within theadapter, moved side to side in or within the adapter, or more generallymoved from one position to another position in or within the adapter.

In some cases, some or all of the adapters described herein may not beused. One or more instrument interfaces 420 can be sterilized beforeloading of the one or more instruments. One or more instrument interface420 can be configured to allow the one or more instruments to rotate (ortransition) using any of the approaches described herein.

Sterile Barrier for Arm

FIG. 5 illustrates the drape 700 for the arm 300 in an unfoldedconfiguration. The drape 700 can be positioned (such as, removablyattached) on the arm 300. The drape 700 can enclose at least a portionof the arm 300 (see, for example, FIGS. 8O-8U). The drape 700 can beflexible or substantially flexible similarly to the drape 600.

As described herein in connection with the drape 600, drape 700 caninclude one or more pockets 720 and 722. These pockets can be similar toany of the pockets described herein, such as any of the pockets 672,674, 676, and 678 of the drape 600. The pockets 720 and 722 can bepositioned on an outer facing surface of the drape 700, which asdescribed herein may provide the sterile barrier. The pockets 720 and722 can be labeled, for example, with labels 728 and 730, respectively.Labels 728 and 730 can be similar to any of the labels described herein,such as any of the labels 666, 667, 668, and 669 of the drape 600. Asdescribed herein, labels 728 and 730 can include indications guiding theuser to insert a particular hand (or portion of the hand) into thepocket. Label 728 can guide the user to insert the left hand (or portionof the left hand) into the pocket 720. Label 730 can guide the user toinsert the right hand (or portion of the right hand) into the pocket722. As described herein with respect to the drape 600, the pockets 720and 722 can be paired. The labels can provide indication of the pairing,such as, include the number “1,” as described herein (for instance, tosignify an earlier or first step in the process for covering the arm 300with the drape 700).

The drape 700 can include one or more attachments or fasteners 710, 712,and 714, which can be similar to any of the fasteners 652 and 662 of thedrape 600. Fastener 710 can be positioned in a region of the drapecovered by (or overlapping with) the pocket 720. Fastener 714 can bepositioned in a region of the drape 700 covered by the pocket 722.Fastener 712 can be positioned in a region (such as, in the middle) ofthe drape 700 not overlapped by a pocket. As described herein, forexample in connection with the fasteners 652 and 662, one or more of thefasteners 710, 712, and 714 can include ferromagnetic material, such asa metal washer, configured to be attached to an attachment or fastenerof the arm 300. As described herein, any of the fasteners 710, 712, and714 can be positioned on or adjacent to an inner facing surface of thedrape 700, which can be configured to come into contact with the arm300.

As described herein in connection with the pockets of the drape 600, thepockets 720 and 722 can facilitate maintaining sterility of the outersurface of the drape when the user is attaching one or more fasteners710, 712, and 714 to the fasteners of the arm 300 (as shown, forexample, in FIGS. 8O-8P). As illustrated in FIGS. 5 and 8O-8P, a pocketmay not be needed to facilitate attachment of the fastener 712 as use ofthe pockets 720 and 722 can be sufficient for attachment of the fastener712. For example, because the fastener 712 can be positioned in themiddle portion of the drape 700, it would be brought into contact orinto proximity of the fastener 402 positioned in the middle of the arm300. In some cases, a pocket overlapping the fastener 712 can beprovided. In some cases, when such pocket is provided, any one or moreof the pockets 720 or 722 can be omitted.

The drape 700 can include a pocket 724, which can be positioned on aflap 760 on the right side of the drape. The pocket 724 can be similarto any of the pockets described herein. The pocket 724 can be positionedon the outer facing surface of the drape 700. The pocket 724 can beconfigured to enclose a portion of the user's hand, such as the lefthand, to facilitate enclosing a portion of the arm 300 with the drape(such as, wrapping the drape 700 around the arm; see, for example, FIGS.8Q-8U). In some cases, the pocket 724 can be smaller than any of thepockets 720 or 722. For example, the pocket 724 can be configured (forexample, sized and shaped) to enclose a portion of the user's hand, suchas fully or partially enclose four fingers excluding the thumb (see, forexample, FIG. 8R). In some cases, the pocket 724 can be configured toenclose less than four fingers. The drape 700 can include a label 729,which can be similar to any of the labels described herein. The label729 can guide the user to insert a portion of the left hand into thepocket 724. The label 729 can include an indication of a step in theprocess for covering the arm 300. Such step can be subsequent to thestep of attaching the fasteners 710, 712, and 714 to the arm 300 (andaffixing the top portion of the drape to the arm). For example, thelabel 729 can include the number “2,” as described herein. The pocket724 can facilitate one or more of maintaining sterility of the outerfacing surface of the drape when the drape is positioned (such as,wrapped around) the arm 300, facilitating wrapping the drape 700 aroundthe arm 300 (for example, by providing an anchor or level to the user),or the like. The pocket 724 may not be paired with another pocket.

Pocket 724 can be used to facilitate wrapping the drape 700 around thearm 300. With reference to FIG. 8Q, the user can detach the flap 760from the drape (such as, from the middle portion of the drape adjacentto the flap 760). For example, the user could remove or break a tearabletab or another removable or detachable closure or attachment. Withreference to FIG. 8R, the user can wrap the flap 760 (and in some casesother portions of the drape) around the arm 300. For example, the usercan wrap the flap around one or more of the sides or back of the arm 300to cover those portions of the arm. Illustrated arrow can indicatedirection for wrapping the drape 700 around the arm 300 (such as,counterclockwise). The user can wrap the drape by using the handpositioned in the pocket 724 (such as, the left hand).

With reference to FIG. 5, the drape can include one or more fasteners740, 742, 744, 746, 748, and 750, which can be similar to any of thefasteners described herein (such as, the fasteners 654, 656, 658, and660 of the drape 600). For example, the fasteners 740, 742, 744, 746,748, and 750 can be VELCRO fasteners. As described herein, the fastenerscan be paired. For example, the pairing can be: 740 with 742, 748 with750, and 744 with 746. Paired fasteners can be attached to one anotherto facilitate covering the arm 300 with the drape 700 (such as, wrappingthe drape around the arm). Fasteners 740, 744, and 748 can be positionedon a flap 762 (on the left side of the drape), such as, on the innerfacing surface of the flap (or on the outer facing surface). Fasteners742, 746, and 750 can be positioned on the flap 760 (on the right sideof the drape), such as, on the opposite surface than the pairedfasteners 740, 748, and 744 (for example, on the outer facing surface).In some cases, fasteners 742, 746, and 750 can be positioned on the samesurface as the parried fasteners 740, 744, and 748.

With reference to FIG. 8S, the drape 700 is illustrated being wrappedaround the arm 300 (such as, after the flap 760 being wrapped around thearm). The user's hand (such as, left hand) can remain in the pocket 724.With the other hand (such as, right hand), the user can wrap the flap762 (and in some cases other portions of the drape) around the portionof the drape wrapped around the arm (such as, the flap 760). The usercan also attach the paired fasteners 740 and 742 to each other, asillustrated in FIG. 8T.

The user may touch or grab the flap 762 as illustrated without the risk(or with low risk) of touching a surface that has come into contact withany non-sterile surfaces of the arm 300. Such risk may not be present(or may be low) because the flap 762 may be attached to the drape (suchas, to the middle portion of the drape adjacent to the flap 762) asdescribed in connection with the flap 760. The user can detach the flap762, for example, by removing or breaking a tearable tab or anotherremovable or detachable closure or attachment. The user can wrap theflap 762 around the flap 760 as illustrated by the arrow in FIG. 8T.Attachment of the fasteners 740 and 742 can secure the top portion ofthe drape 700 around the arm 300. Attachment of paired fasteners 748 and750 can similarly facilitate securing the middle portion of the drapearound the arm 300.

As illustrated in FIG. 5, the pocket 724 can be positioned adjacent to(or overlapping) the fastener 742. This can facilitate attaching thefastener 742 to the fastener 740. In some cases, one or more pockets,which can be similar to the pocket 724, can be positioned on the flap762. For example, a pocket similar to the pocket 724 can be positionedadjacent (or overlapping) the fastener 740. One or more pockets can bepositioned adjacent to (or overlapping) one or more fasteners 746, 748,and 750.

Drape 700 can include a pocket 726, which can be similar to the pocket724. Pocket 726 can be positioned in the bottom portion of the drape,such as in the bottom portion of the flap 762. A label 731, which can besimilar to any of the labels described herein, can guide the user toinsert a hand (or portion of the hand), such as the right hand, into thepocket 726. The label 731 can include an indication of a step in theprocess of covering the arm subsequent to attaching the fasteners 740and 742. For example, the label 729 can include the number “3,” asdescribed herein. The pocket 726 may not be paired with another pocket.

As illustrated in FIG. 8U, the pocket 726 can facilitate attaching thefasteners 744 and 746. For example, the fastener 744 can be positionedon the outer facing surface of the pocket 726. With reference to FIG. 5,the pocket 726 can overlap the fastener 744. This can provide an anchoror lever to the user for facilitating attachment of the fasteners 744and 746.

Attachment of the fasteners 740 and 742 can secure (or tighten) thebottom portion of the drape 700 around the arm 300. As illustrated inFIG. 8U, the bottom portion of the drape 700 can partially overlap thetop portion of the drape 600. The drapes 600 or 700 can moveindependently of the other, for example, due to the drapes beingseparate (or modular). Movement of one drape may not cause movement ofthe other drape. Such modularity and independence of the drapes providesadvantages over existing monolithic drapes that are large, bulky, andrequire multiple users for installation. Some of the advantages includefacilitating secure and tight fit of the drapes around different roboticsurgery system components that have different shapes and sizes (such as,the central unit 400 and the arm 300), facilitating easier and moreefficient management and installation of the drapes (for example,facilitating installation by a single user, such as sterile nurse),facilitating quicker installation, and promoting safety by lessening therisk of losing sterility during installation (for example, as a resultof a sterile surface of the drape coming into contact with a non-sterilesurface of a system component).

In some cases, the drapes 600 and 700 can be coupled. For example, thedrapes 600 and 700 can be attached to each other using any of the one ormore fasteners described herein.

In some cases, any of the pockets, fasteners, or labels illustrated inFIG. 5 can be positioned in a different location (including on adifferent surface) or removed. Additional pockets, fasteners, or labelsfasteners can be added. In some cases, the drape 700 may include anadditional drape region or portion (shown, for example, as 770 in FIGS.8Q to 8T) positioned above one or more of the pockets 720 and 722. Theadditional drape portion may include a more rigid material (than that ofthe material of the drape 700) in order to cause the additional drapeportion to remain upright during the medical procedure. In some cases,the additional drape portion can alternatively or additionally includesupports (such as, supporting membranes) configured to hold theadditional drape portion upright. The inclusion of the additional drapeportion may be useful when a sterile barrier is needed above the pointor region of fastening of the drape 700 to or on the robotic surgerysystem. The inclusion of the additional drape portion may additionallyor alternatively be useful to facilitate fastening of the drape 700 tothe arm 300 by the user (such as, the sterile nurse) of an averageheight without needing to otherwise be supported (for example, by theuse of a ladder) in order to reach the fasteners on the arm 300, whileproviding sufficient sterile barrier coverage of the arm above thefasteners.

Sterile Barrier for Column

FIG. 6A illustrates the drape 800 in an unfolded configuration. Thedrape 800 can be positioned on the column 200 (such as, removablyattached). The drape 800 can cover at least a portion of the column 200(see, for example, FIGS. 8V-8W). The drape 800 can be flexible orsubstantially flexible similarly to any of the drapes 600 or 700.

As described herein in connection with any of the drapes 600 or 700, thedrape 800 can include one or more pockets 820 and 822. These pockets canbe similar to any of the pockets described herein, such as any of thepockets 672, 674, 676, and 678 of the drape 600 or any of the pockets720 and 722 of the drape 700. The pockets 820 and 822 can be positionedon an outer facing surface of the drape 800, which as described hereinmay provide the sterile barrier. The pockets 820 and 822 can be labeled,for example, with labels 828 and 830, respectively. Labels 828 and 830can be similar to any of the labels described herein, such as any of thelabels 666, 667, 668, and 669 of the drape 600 or any of the labels 728and 730 of the drape 700. As described herein, labels 828 and 830 caninclude indications guiding the user to insert a particular hand (orportion of the hand) into the pocket. Label 828 can guide the user toinsert the left hand (or portion of the left hand) into the pocket 820.Label 830 can guide the user to insert the right hand (or portion of theright hand) into the pocket 822. As described herein with respect to thedrape 600 or 700, the pockets 820 and 822 can be paired. The labels canprovide indication of the pairing, such as, include the number “1,” asdescribed herein (for instance, to signify an earlier or first step inthe process for covering the column 200 with the drape 800).

The drape 800 can include one or more attachments or fasteners 810, 812,and 814, which can be similar to any of the fasteners 652 and 662 of thedrape 600 or fasteners 710, 712, and 714 of the drape 700. Fastener 810can be positioned in a region of the drape covered by (or overlappingwith) the pocket 820. Fastener 814 can be positioned in a region of thedrape covered by the pocket 822. Fastener 812 can be positioned in theregion of the drape (such as, in the middle) not overlapped by a pocket.As described herein, for example in connection with the fasteners 652and 662 of the drape 600 or fasteners 710, 712, and 714 of the drape700, one or more of the fasteners 810, 812, and 814 can includeferromagnetic material, such as a metal washer, configured to beattached to an attachment or fastener of the column 200. As describedherein, any of the fasteners 810, 812, and 814 can be positioned on oradjacent to an inner facing surface of the drape 800, which can beconfigured to come into contact with the column 200.

As described herein in connection with the pockets of the drape 600 or700, the pockets 820 and 822 can facilitate maintaining sterility of theouter surface of the drape when the user is attaching one or morefasteners 810, 812, and 814 to the fasteners of the column 200 (asshown, for example, in FIGS. 8V-8W). As illustrated in FIGS. 6A and8V-8W, a pocket may not be needed to facilitate attachment of thefastener 812 as use of the pockets 820 and 822 can be sufficient forattachment of the fastener 812 (similarly, to the drape 700). Forexample, because the fastener 812 can be positioned in the middleportion of the drape 800, it would be brought into contact or intoproximity of one of the fasteners 202, 204, 206, or 208 positioned onthe column 200. In some cases, a pocket overlapping the fastener 812 canbe provided. In some cases, when such pocket is provided, any one ormore of the pockets 820 or 822 can be omitted.

Providing a sterile barrier for the column 200 may be advantageous incase the central unit 400, which can be moveable, comes into contactwith the column, another sterile object (such as, an instrument) comesinto contact with the column, a sterile user comes into contact with thecolumn, or the like. In some cases, the drape 800 may not be configured(such as sized and shaped) to wrap around the column 200 or a portion ofthe column because protecting a portion of the column 200 (for example,the portion facing the central unit 400 and/or the patient during themedical procedure) may be sufficient. In some cases, the drape 800 canbe configured to be wrapped around the column 200 (or portion thereof),as described herein in connection with one or more of the drapes 600 or700.

The drape 800 can be positioned in different orientations (or positions)to cover different portions of the column 200. With reference to FIG.1B-1C, four fasteners 202, 204, 206, and 208 can be positioned on thecolumn 200. The drape 800 can include three fasteners 810, 812, and 814.Because the number of fasteners of the column 200 can exceed the numberof fasteners of the drape 800, the drape 800 can be positioned indifferent orientations to cover the column 200.

Positioning the drape in different orientations can provide a sterilebarrier and/or facilitate protecting the column 200 from coming intocontact with blood, fluids, tissue, or the like during the medicalprocedure. Orientation of the drape 800 can be selected based on thelocation of the column 200 relative to the patient, type of medicalprocedure, or the like. For example, the patient cart 104 (which may bemoveable) can be positioned in different locations in the operatingroom. Depending on the location of the patient cart 104, a particularorientation of the drape 800 can be selected to provide a sterilebarrier for a particular portion of the column 200 and/or protect theparticular portion of the column 200 from being splashed, stained, orthe like during the medical procedure.

FIG. 6B illustrates positioning of the fasteners on the column 200. Forexample, fastener 202 can be positioned in the front portion of thecolumn, which can face the central unit 400 (see also FIG. 1B). Thedrape 800 can be positioned on, affixed to, or attached to the column200 in one or more of the following orientations:

-   -   Front (attached to fasteners 208, 202, and 204),    -   Left (attached to fasteners 202, 208, and 206),    -   Right (attached to fasteners 202, 204, and 206), or    -   Back (attached to fasteners 208, 206, and 204)

Any of the fasteners 810, 812, and 814 of the drape 800 can be attachedto (or coupled with) any of the fasteners 202, 204, 206, and 208 of thecolumn 200. With reference to FIGS. 8V-8W, positioning the drape 800 onthe column 200 is illustrated. As illustrated in FIG. 8V, fastener 812of the drape 800 can be attached to any of the fasteners 202, 204, 206,and 208 of the column 200.

The drape 800 can include an additional drape portion 870 (shown, forexample, in FIG. 8V). The additional drape portion 870 can be the sameor similar to the additional drape portion 770 described herein.

Generally, any robotic surgery system component can include morefasteners than the sterile barrier configured to cover the component.This can facilitate positioning or attaching the sterile barrier indifferent orientations to cover different portions of the component. Insome cases, more or less fasteners than described herein can bepositioned on the any robotic surgery system component to facilitategreater or lesser number of orientations of a sterile barrier coveringthe component. In some cases, more or less fasteners than describedherein can be positioned on any of the sterile barrier to facilitatelesser or greater number of orientations.

In some cases, a fastener of a robotic surgery system component can haveat least one dimension that is different a corresponding dimension of afastener of the sterile barrier. This can facilitate positioning orattaching the sterile barrier in different orientations to coverdifferent portions of the component. With reference to FIG. 11, asterile barrier 1400 can include a fastener 1402. A robotic surgerysystem component 1450 can include a fastener 1452. The length of thefastener 1452 can exceed or be longer than the length of the fastener1402, permitting the sterile barrier 1400 to be positioned in variousorientations to cover at least a portion of the component 1450. In somecases, the length of the fastener 1402 can be longer than the length ofthe fastener 1452, while permitting the same or similar purpose to beachieved. Excess portion of the sterile barrier 1400 that is notattached to the fastener 1452 can be removed or folded.

Fasteners 1402 and 1452 can include any one or more fasteners describedherein, such as ferromagnetic and magnetic materials, VELCRO, adhesive,buttons, zippers, or the like. For example, fasteners 1402 and 1452 caninclude continuous ferromagnetic and magnetic portions. As anotherexample, fasteners 1402 and 1452 can include discontinuous ferromagneticand magnetic sections to facilitate positioning of the sterile barrierin a number of fixed orientations.

Labels

FIG. 7A illustrates a label 902 that can indicate position of any of thefasteners of the components of the robotic surgery system, such as anyof the fasteners 202, 204, 206, and 208 of the column 200, 302 and 304of the central unit 400, and 402, 404, and 406 of the arm 300. The label902 can be attached to or affixed over or adjacent to any of thefasteners. The label 902 can match the dimensions of the fasteners. Thelabel 902 can indicate positions of any of the fasteners of the drapes600, 700, and 800 that are configured to be attached to any of thefasteners of the components of the robotic surgery system, such as anyof the fasteners 652 and 662 of the drape 600, any of the fasteners 710,712, and 714 of the drape 700, and any of the fasteners 810, 812, and814 of the drape 800. The label 902 can provide a visual cue to the userwhere a particular fastener is located and/or what action to take (suchas, affix the particular fastener to another fastener).

With reference to FIG. 7B, labels 910 and 912 can guide insertion of theright and left hand, respectively, into any of the pockets of the drapes600, 700, and 800, as described herein. With reference to FIG. 7C,labels 920 and 922 can be similar to the labels 910 and 912, but withaddition of indicia (such as “1”) to indicate one or more of pairing oflabels (such as, left and right hand labels) or a particular step in theprocess for covering a component with a sterile barrier, as describedherein. The arrows in the labels 910, 912, 920, and 922 can indicate adirection for inserting the hand.

In some cases, any of the labels 910, 912, 920, and 922 can includecontrast between one or more of the hand or arrow and the rest of thelabel. In some cases, any of the labels 920 and 922 can include contrastbetween one or more of the numbers or the circles outlining the numbersand the rest of the label. Contrast can include one or more of colorcontrast, texture contrast, difference in material, or the like.

The dashed circle in FIG. 7A can represent a portion of the component ordrape on which the label 902 is positioned (such as, a fastener). Thedashed rectangles in FIGS. 7A-7B can represent a portion of the drape onwhich any of the illustrated labels is positioned.

Covering Components of Robotic Surgery System with Sterile Barriers

FIGS. 8A-8W illustrate the steps of covering components of the roboticsurgery system with one or more sterile barriers. The sequenceillustrated in FIGS. 8A-8W can correspond to the sequence of the stepsfor covering the components of the robotic surgery system with one ormore sterile barriers. In some cases, steps can be performed indifferent order as depicted in FIGS. 8A-8W, certain steps can be omittedor replaced, additional steps can be added, or the like.

Certain figures illustrate positioning of arms and/or hands of the userfacing the robotic surgery system components and affixing varioussterile barriers to the components. The orientation of the user andarms/hands in any of the illustrations can indicate whether leftarm/hand or right arm/hand is being used by the user. For example, withreference to FIG. 8B, an arm/hand labeled 850 can correspond to the leftarm/hand, and arm/hand labeled 852 can correspond to the right arm/hand.

The illustrations in FIGS. 8A-8W are described in the foregoing sectionsof the disclosure. The following sections provide summary of theillustrated steps as well as certain additional details. In some cases,the steps illustrated in FIGS. 8A-8W can be performed by a sterilenurse.

FIG. 8A illustrates attachment of the drape coupler 610 to the centralunit 400 (such as, to the bottom surface of the central unit asillustrated by the arrow). FIGS. 8B-8C illustrates spreading out thedrape 600 over the central unit 400 with use of the pockets 678 and 672(such as, as shown in the direction of the arrows). FIG. 8C illustratesone or more handles 450 for moving the central unit 400. Any of thehandles 450 can include a control 452, such as a button, for moving thecentral unit 400. FIG. 8D illustrates attaching the fasteners 662 and652 of the drape to the fasteners 302 and 304 of the central unit 400.In this step, the user can affix the top portion of the drape 600 on orto the central unit 400. FIG. 8E illustrates wrapping the drape around,for example, the front portion of the central unit 400 (such as, in thedirection of the arrow as shown) with use of the pockets 674 and 676.Also illustrated is a closure or fastener 602. With reference to FIGS.8F-8I, one or more fasteners 602 can be configured to wrap the drape 600around one or more protrusions of the central unit 400. The protrusionscan be handles 450. The handles 450 can be configured to facilitatemovement of the central unit 400 by the user. The fasteners 602 caninclude one or more bendable or substantially bendable materials, suchas metal (for instance, metal wire), plastic, or the like. The one ormore materials of the fasteners 602 can be resilient or substantiallyresilient, ductile or substantially ductile, and/or elastic orsubstantially elastic. The fasteners 602 can be returned to the original(such as, unbent or substantially unbent) shape by the user. Thefasteners 602 can be further bent to another desired shape. Thefasteners 602 can be deformable without breaking, fracture, or the like.The fasteners 602 can be used to tighten the drape 600 around portions(such as, a handle 450) of the central unit 400.

FIGS. 8E-8F illustrate wrapping the drape 600 around, for example, thefront portion of the central unit 400. This can be accomplished byattaching the fastener 656 to the second fastener 652, and attaching thefastener 658 to the second fastener 662. The user can position theuser's hands in the pockets 674 and 676 as shown. FIG. 8G illustratestightening the drape 600 around, for example, the rear portion of thecentral unit 400 (such as, in the direction shown by the arrows) byattaching the fasteners 654 and 660 to each other.

FIG. 8H illustrates the drape 600 wrapped around the central unit 400.As shown, the drape 600 can cover a portion of the arm 300, such as thebottom portion of the arm. The arrow in FIG. 8H can illustrate thelocation for positioning the sterile drivers 232 (for example, on theinterface 500 of the central unit 400).

FIG. 8I illustrates moving the central unit 400 (such as, in thedirection of the arrows) for positioning one or more sterile adapters680. The central unit 400 can be rotated. FIG. 8J illustratespositioning of the one or more sterile adapters 680, for example, asillustrated by the arrow. The central unit 400 can be moved (asillustrated in FIG. 8I) and/or tilted (as illustrated in FIG. 8J) byactivating one or more controls 452 positioned on the one or morehandles 450. For example, a button 452 (or any two or more buttons 452)can be pressed to move and/or tilt the central unit 400. FIGS. 8K-8Millustrate, in greater details, attaching the one or more sterileadapters 680 to the one or more instrument interfaces 420.

As described herein, the actuators 422 can be positioned in a defaultalignment to facilitate engagement with the surgical instrumentactuators 322 when the surgical instrument is loaded. The surgicalinstrument actuators 322 can also be positioned in a default alignment.As illustrated in FIG. 8L, the actuators 422 can be centrally aligned inthe default alignment. The surgical instrument actuators 322 can also becentrally aligned in the default alignment. The actuator covers 622 ofthe adapter 680 can be maintained or fixed in a default alignment, whichcan match the default alignment of the actuators 422 (and/or theinstrument actuators 322). As illustrated in FIG. 8N, a retainer 698 canmaintain the actuator covers 622 in the default alignment. The retainer698 can surround the actuators covers 622 as shown. The retainer 698 canbe removable. The retainer 698 can be attached to the surface of theadapter configured to face away from the instrument interface 420. Afterthe adapter 680 is attached to the instrument interface 420 (and theactuator covers 622 are engaged with the actuators 422), the retainercan be removed. In some cases, the retainer 698 can include adhesivetape attached to one or more surfaces of the adapter 680 surrounding theactuator covers as shown. The adhesive tape can be removed afterinstallation of the adapter 680.

In some cases, the actuator covers 622 can be maintained in the defaultalignment by being connected together with one or more strips. Thestrips can include material that can be removed easily, such as plastic.For example, adjacent actuator covers can be connected together withplastic strips or pieces. When the actuator covers 622 are moved due tomovement of the actuators 422, the plastic pieces would break off. Theactuator covers 622 can include groves or channels for attaching theplastic pieces. The channels can be formed during, for example, moldingof the actuator covers. In some cases, a removable cover can be used tomaintain default alignment of the actuator covers. After the adapter 680is attached to the instrument interface, the cover can be removed topermit independent movement of the actuator covers 622.

FIGS. 8O-8U illustrate covering the arm 300 with the drape 700. FIGS.8O-8P illustrate attaching the fasteners 710, 712, and 714 to thefasteners 402, 404, and 406 of the arm 300 with use of the pockets 720and 722 (for example, in the direction of the arrow in FIG. 8O). In thisstep, the user can affix the top portion of the drape 700 on or to thearm 300. FIG. 8Q illustrates detaching the flap 760 from the drape 700,such as, in the direction of the arrow. FIG. 8R illustrates wrapping theflap 760 (and in some cases other portions of the drape) around the arm300 with use of the pocket 724, such as, in the direction of the arrow.For example, the left hand (or portion thereof) of the user can bepositioned in the pocket 724. The user can use the other hand (such as,the right hand) to assist with the wrapping of the drape 700. A pocketfor positioning the other hand may not be needed since the risk theother hand of coming into contact with a non-sterile surface may be lowor not present because any of the flaps 760 or 762 is unlikely to havecome into contact with a non-sterile surface.

FIGS. 8S-8T illustrate wrapping the drape around the arm 300. FIG. 8Sillustrates the flap 760 (and in some cases other portions of the drape)being wrapped around the arm 300, such as, in the direction illustratedby the arrow. The user's hand can remain in the pocket 724. The otherflap 762 is illustrated as being wrapped around a portion of the drape(such as, the flap 760), such as, in the direction shown by the arrow inFIG. 8T. The user can wrap the flap 762 with the other hand notpositioned in the pocket 724 (such as, the right hand). FIG. 8Tillustrates attaching fasteners 740 and 742 to each other to secure(such as, tighten) at least the top portion of the drape 700. Asdescribed herein, the middle portion of the drape can be similarlysecured by attaching the fasteners 748 and 750. FIG. 8U illustratessecuring (for example, tightening) the bottom portion of the drape 700by attaching the fasteners 744 and 746 to each other with the use of thepocket 726. The drape 700 can be tightened in the direction of theillustrated arrows. The bottom portion of the drape 700 can partiallyoverlap the top portion of the drape 600, as described herein. FIGS.8Q-8T illustrate the additional drape portion 770, which may beoptional.

FIGS. 8V-8W illustrate covering the column 200 with the drape 800. Thefasteners 810, 812, and 814 are attached (such as, in the direction ofthe illustrated arrows) to three of the four fasteners 202, 204, 206,and 208 of the column 200 with use of the pockets 820 and 822 toposition the drape 800 in the desired orientation. FIGS. 8V-8Willustrate the additional drape portion 870, which may be optional.

In some cases, sterile barrier for the central unit 400 can be installedfirst. Installation of the sterile barrier for the central unit 400 canbe performed in the following order: sterile barrier 650, followed byone or more sterile drivers 232, and followed by one or more sterileadapters 680. Sterile barrier 700 for the arm 300 can be installed next.Sterile barrier 800 for the column 200 can be installed last. In somecases, steps can be performed in different order, certain steps can beomitted or replaced, additional steps can be added, or the like.

Sterile barriers described herein can be removable. The user, such as,the sterile nurse (and/or non-sterile nurse), can remove the sterilebarriers. For example, the user can follow reverse steps for removingthe sterile barriers.

Sterile Barrier Fasteners for Robotic Surgery System Components

As described herein, the components of the robotic surgery system caninclude fasteners for attaching fasteners of the sterile barriers. Forexample, the column 200 can include fasteners 202, 204, 206, and 208,the central unit 300 can include fasteners 302 and 304 of the centralunit, and the arm can include fasteners 402, 404, and 406. The fastenerscan be positioned on the external surfaces of the components. Thefasteners can be configured to support the sterile barriers. Thefasteners can be configured to withstand the sheer forces that may beapplied to the sterile barriers during the medical procedure whilemaintaining secure attachment.

In some cases, any of the fasteners can be magnetic fasteners. Themagnetic fasteners can be configured to provide secure support for thesterile barriers during the medical procedure. One or more magneticmaterials of a fastener can be selected to have sufficient strength tosupport the sterile barrier attached to the component. Alternatively oradditionally, a configuration of the fastener can be important forproviding secure support for the sterile barrier.

FIG. 9 illustrates configurations 1010 and 1020 of a fastener. Thefastener can include a recess defined by a bottom surface and sidesurfaces or walls 1012 in the configuration 1010 and side surfaces orwalls 1022 in the configuration 1020. Corresponding fastener 1030 of thesterile barrier can be at least partially received or positioned in therecess. This can facilitate secure attachment.

Magnetic material 1040 (such as, a permanent magnet) can be positionedin the recess (such as, at the bottom of the recess) in theconfigurations 1010 and 1020. The side walls 1012 in the configuration1010 can form a right (or substantially right angle) with the bottom ofthe recess. The side walls 1012 in the configuration 1010 can form aright (or substantially right) angle with the exterior surface of therobotic surgery system component. In this configuration, the fastener1030 of a sterile barrier may be more securely attached to the fastenerof the robotic surgery component due to, for example, presence in therecess of one or more edges, including sharp edges (such as, edgesformed at a right angle or substantially right angle). This canfacilitate secure attachment by preventing an unintended dislodging ordisengagement of the fastener 1030, while facilitating efficientdisengagement by the user when the sterile barrier is being repositionedor removed.

The side walls 1022 in the configuration 1020 can be curved asillustrated. The transitions made by the side walls 1022 can be smooth.The angle formed by the side walls 1022 with the bottom of the recess(and/or the exterior surface of the robotic surgery system component)can be more acute than a right (or substantially right) angle, which maycause the fastener 1030 to dislodge or disengage more easily than in theconfiguration 1010. In some cases, the side walls in the configuration1020 can be straight (rather than curved), but form an acute angle withthe bottom of the recess (and/or the exterior surface of the roboticsurgery system component).

Detection of Positioning and Orientation of Sterile Barriers

The robotic surgery system can be configured to detect one or more ofpositioning and orientation of the sterile barriers. This can beadvantageous for verifying that the robotic surgery system is properlycovered prior to the start of the medical procedure. In some cases, theelectronic circuitry 114 alone or in combination with the electroniccircuitry 118 can perform the detection of one or more of thepositioning or orientation. Indication corresponding to the detectioncan be provided to the user visually (such as, via any of the displays120 or 123), audibly, tactilely, and/or the like.

One or more detectors or sensors can be used to facilitate thedetection. The sensors can include proximity sensors, such as one ormore of capacitive sensors, photoelectric sensors, inductive sensors(which may be used for detecting a metal object, such as a fastener ormetal tracing, of the sterile barrier), RFID detectors, or the like. Theone or more sensors can be coupled to the electronic circuitry 118and/or 114. A sensor can detect whether a sterile barrier (or portion ofthe sterile barrier) is in contact with a fastener of any of thecomponents of the robotic surgery system or present within a thresholddistance of the sensor. In some cases, the threshold distance may be afew millimeters, a few centimeters, or a few inches. In some cases, thesensor can detect contact of the sterile barrier (or portion thereof)with a fastener. For example, the sensor can detect positioning offerromagnetic material, such as metal washer, metal trace, or the likeof the sterile barrier on the fastener of the robotic surgery system.The electronic circuitry 118 and/or 114 can use data provided by the oneor more proximity sensors to determine one or more of positioning ororientation of the sterile barrier.

One or more sensors can be positioned on the one or more robotic surgerysystem components. For example, one or more sensors can be positioned inor adjacent to the recesses described in connection with FIGS. 9A-9B.One or more sensors can be calibrated to perform the detection. Forexample, a sensor can be calibrated to perform the detection when thesterile barrier is attached to (such as, makes contact with) orpositioned within threshold distance of one or more fasteners of thecomponents of robotic surgery system, but not when the sterile barrieris positioned at a distance farther than the threshold distance.

In some cases, orientation of the sterile barrier can be detected basedon a determination of which of the one or more fasteners of thecomponents of the robotic surgery system the sterile barrier is attachedto. For example, as described herein, the sterile drape 800 can beattached (or positioned) in multiple orientations. Determination thatthe drape fasteners are attached to (or coupled with) a set of thefasteners 202, 204, 206, and 208 of the column 200 can be used toindicate that the drape 800 is positioned. Depending on thedetermination of which of the fasteners 202, 204, 206, and 208 the drapefasteners are attached to, orientation of the drape can be determined.For instance, determination of attachment of the drape fasteners to thefasteners 208, 202, and 204 of the column 200 can indicate frontorientation of the drape, as described herein. As another example, oneor more RFID tags of the sterile barrier can be detected by one or moreRFID detectors of the robotic surgery system. Different portions of thesterile barrier can include different RFID tags (for example, differenttags can transmit different unique identifiers). Detection of aparticular RFID tag from a set of different RFID tag by an RFID tagdetector can indicate positioning and orientation of the sterilebarrier.

Based on the detection of one or more of positioning and orientation ofa sterile barrier, a determination of whether the sterile barrier iscorrectly attached can be made. For example, if the correct orientationof the sterile drape 800 is the front orientation, determination thatthe drape 800 is attached in the front orientation can indicate that theattachment of the drape is correct, or otherwise in the desiredorientation. Indication of whether the attachment is correct or not canbe provided to the user visually (such as, via any of the displays 120or 123), audibly, tactilely, and/or the like.

Sterile Barrier Kit

The sterile barriers described herein can be packaged in sterilepackaging and provided as a one or more kits. The packaging can includeone or more bags, pouches, boxes, trays, or the like. FIG. 10illustrates a kit 1210, which can include the sterile barrier 650, oneor more sterile drivers 232, and one or more sterile adapters 680 forthe central unit 400. The kit 1210 can include the sterile barrier 700for the arm 300. A kit 1220 can include the sterile barrier 700 for thecolumn 200. In some cases, kits 1210 and 1220 can be combined into asingle kit. Each sterile barrier in any of the kits can be sterile. Eachsterile barrier in any of the kits can be packaged into sterilepackaging. The illustrations shown in FIG. 10 can correspond to labelsincluded in or on the packaging for the sterile barriers.

In some cases, the numbering 1 (1A, 1B, 1C), 2, and 3 can indicate theorder of steps for covering the robotic surgery system with sterilebarriers, as described herein in connection with FIGS. 8A-8W. One ormore numbers can be omitted in some cases, different numbers can beused, the numbers can be in different order, or the like. Theillustrated text can be fully or partially omitted, different text canbe used, or the like.

Other Variations

Those skilled in the art will appreciate that, in some embodiments,additional components and/or steps can be utilized, and disclosedcomponents and/or steps can be combined or omitted. For example,although some embodiments are described in connection with a roboticsurgery system, the disclosure is not so limited. Systems, devices, andmethods described herein can be applicable to medical devices andmedical procedures in general, among other uses.

In some cases, one or more surfaces of one or more components of therobotic surgery system may be sterilized (for example, one or moreexternal surfaces and/or other parts can be sterilized), and any of thesterile barriers described herein may not be used. In some cases,magnetic material can be included in the fasteners of the sterilebarriers and ferromagnetic material can be included in the fasteners ofthe one or more components of the robotic surgery system. In some cases,in addition to or instead of using magnetic force(s) for attachment, oneor more fasteners can include adhesive, buttons, VELCRO, zippers, or thelike. Although certain sterile barriers are described as drapes,barriers other than drapes can be used. Any of the fasteners disclosedherein can be referred to as a closure, attachment, or the like. In somecases, one or more pockets described herein can be omitted. The user maybe able to grip a particular fastener through the sterile surface of thedrape, such as the outer facing surface. Although certain components areillustrated as being circular, the components can have any shape, suchas square, rectangular, or the like.

The foregoing description details certain embodiments of the systems,devices, and methods disclosed herein. It will be appreciated, however,that no matter how detailed the foregoing appears in text, the systems,devices, and methods can be practiced in many ways. The use ofparticular terminology when describing certain features or aspects ofthe disclosure should not be taken to imply that the terminology isbeing redefined herein to be restricted to including any specificcharacteristics of the features or aspects of the technology with whichthat terminology is associated.

It will be appreciated by those skilled in the art that variousmodifications and changes can be made without departing from the scopeof the described technology. Such modifications and changes are intendedto fall within the scope of the embodiments. It will also be appreciatedby those of skill in the art that parts included in one embodiment areinterchangeable with other embodiments; one or more parts from adepicted embodiment can be included with other depicted embodiments inany combination. For example, any of the various components describedherein and/or depicted in the figures can be combined, interchanged, orexcluded from other embodiments.

With respect to the use of substantially any plural and/or singularterms herein, those having skill in the art can translate from theplural to the singular and/or from the singular to the plural as isappropriate to the context and/or application. The varioussingular/plural permutations can be expressly set forth herein for sakeof clarity.

Directional terms used herein (for example, top, bottom, side, up, down,inward, outward, etc.) are generally used with reference to theorientation or perspective shown in the figures and are not intended tobe limiting. For example, positioning “above” described herein can referto positioning below or on one of sides. Thus, features described asbeing “above” may be included below, on one of sides, or the like.

It will be understood by those within the art that, in general, termsused herein are generally intended as “open” terms (for example, theterm “including” should be interpreted as “including but not limitedto,” the term “having” should be interpreted as “having at least,” theterm “includes” should be interpreted as “includes but is not limitedto,” etc.). It will be further understood by those within the art thatif a specific number of an introduced claim recitation is intended, suchan intent will be explicitly recited in the claim, and in the absence ofsuch recitation no such intent is present. For example, as an aid tounderstanding, the following appended claims can contain usage of theintroductory phrases “at least one” and “one or more” to introduce claimrecitations. However, the use of such phrases should not be construed toimply that the introduction of a claim recitation by the indefinitearticles “a” or “an” limits any particular claim containing suchintroduced claim recitation to embodiments containing only one suchrecitation, even when the same claim includes the introductory phrases“one or more” or “at least one” and indefinite articles such as “a” or“an” (for example, “a” and/or “an” should typically be interpreted tomean “at least one” or “one or more”); the same holds true for the useof definite articles used to introduce claim recitations. In addition,even if a specific number of an introduced claim recitation isexplicitly recited, those skilled in the art will recognize that suchrecitation should typically be interpreted to mean at least the recitednumber (for example, the bare recitation of “two recitations,” withoutother modifiers, typically means at least two recitations, or two ormore recitations).

The term “comprising” as used herein is synonymous with “including,”“containing,” or “characterized by,” and is inclusive or open-ended anddoes not exclude additional, unrecited elements or method steps.

Conditional language, such as “can,” “could,” “might,” or “may,” unlessspecifically stated otherwise, or otherwise understood within thecontext as used, is generally intended to convey that certainembodiments include, while other embodiments do not include, certainfeatures, elements, and/or steps. Thus, such conditional language is notgenerally intended to imply that features, elements, and/or steps are inany way required for one or more embodiments or that one or moreembodiments necessarily include logic for deciding, with or without userinput or prompting, whether these features, elements, and/or steps areincluded or are to be performed in any particular embodiment.

Language of degree used herein, such as the terms “approximately,”“about,” “generally,” and “substantially” as used herein represent avalue, amount, or characteristic close to the stated value, amount, orcharacteristic that still performs a desired function and/or achieves adesired result. For example, the terms “approximately”, “about”,“generally,” and “substantially” may refer to an amount that is withinless than 10% of, within less than 5% of, within less than 1% of, withinless than 0.1% of, and/or within less than 0.01% of the stated amount.

It will be further understood by those within the art that anydisjunctive word and/or phrase presenting two or more alternative terms,whether in the description, claims, or drawings, can be understood tocontemplate the possibilities of including one of the terms, either ofthe terms, or both terms. For example, the phrase “A or B” will beunderstood to include the possibilities of “A” or “B” or “A and B.”Further, the term “each,” as used herein, in addition to having itsordinary meaning, can mean any subset of a set of elements to which theterm “each” is applied.

Conjunctive language such as the phrase “at least one of X, Y, and Z,”unless specifically stated otherwise, is otherwise understood with thecontext as used in general to convey that an item, term, etc. may beeither X, Y, or Z. Thus, such conjunctive language is not generallyintended to imply that certain embodiments require the presence of atleast one of X, at least one of Y, and at least one of Z.

The above description discloses embodiments of systems, apparatuses,devices, methods, and materials of the present disclosure. Thisdisclosure is susceptible to modifications in the components, parts,elements, steps, and materials, as well as alterations in thefabrication methods and equipment. Such modifications will becomeapparent to those skilled in the art from a consideration of thisdisclosure or practice of the disclosure. Consequently, it is notintended that the disclosure be limited to the specific embodimentsdisclosed herein, but that it cover all modifications and alternativescoming within the scope and spirit of the subject matter embodied in thefollowing claims.

1. A sterile barrier system for a robotic surgery apparatus, the systemcomprising: a drape coupler comprising: an external surface configuredto face a first surface of a first portion of the robotic surgeryapparatus, at least one drape coupler fastener positioned at leastpartially on the external surface of the drape coupler and configured toremovably attach the drape coupler to the first surface of the firstportion of the robotic surgery apparatus, the drape coupler configuredto at least partially cover the first surface, and an opening configuredto expose a surgical instrument interface of the first portion of therobotic surgery apparatus, the surgical instrument interface configuredto cause actuation of a surgical instrument mounted on the surgicalinstrument interface; a drape made of a flexible material and coupled tothe drape coupler, the drape configured to wrap around a second surfaceof the first portion of the robotic surgery apparatus, the secondsurface different from the first surface; and a sterile adapterconfigured to be received at the opening and to be removably attached tothe surgical instrument interface, the sterile adapter configured toreceive and support the surgical instrument and provide a sterilebarrier between the surgical instrument interface and the surgicalinstrument, the sterile adapter including a plurality of actuator coversconfigured to couple with a plurality of instrument actuators positionedon the surgical instrument interface.
 2. The system of claim 1, wherein:the first portion of the robotic surgery apparatus comprises amanipulator unit; the first surface comprises a manipulating surface ofthe manipulator unit; the at least one drape coupler fastener isconfigured to removably attach the drape coupler to the manipulatingsurface of the manipulator unit; the second surface comprises at leastone side surface of the manipulator unit; and the drape is configured toenclose the at least one side surface of the manipulator unit.
 3. Thesystem of claim 1, wherein the at least one drape coupler fastenercomprises ferromagnetic material configured to be attached to a magnetpositioned on the first surface.
 4. The system of claim 1, wherein theat least one drape coupler fastener comprises a plurality of fastenerscomprising ferromagnetic material and configured to be attached to aplurality of magnets positioned on the first surface.
 5. The system ofclaim 1, wherein the drape is coupled to the drape coupler along aperimeter of the drape coupler.
 6. (canceled)
 7. The system of claim 1,wherein the drape coupler further comprises at least one removableprotector configured to cover the opening of the drape coupler.
 8. Thesystem of claim 1, wherein the drape coupler further comprises at leastone region made at least partially of a flexible material, the at leastone region positioned adjacent to the opening and configured to collapseand expand.
 9. The system of claim 8, wherein the at least one regioncomprises first and second regions, the first region positioned adjacentto a first side of the opening and the second region positioned adjacentto a second side of the opening opposite the first side, the first andsecond regions configured to collapse and expand in response to movementof the opening.
 10. The system of claim 8, wherein at least one regioncomprises an insert made at least partially of material that is morerigid than the material of the at least one region, the insertconfigured to cause the flexible material of the at least one region tofold when the at least one region is collapsed.
 11. The system of claim10, wherein the insert includes at least one tapered edge.
 12. Thesystem of claim 1, wherein the drape comprises at least one drapefastener configured to removably attach the drape to a third surface ofthe first portion of the robotic surgery apparatus.
 13. The system ofclaim 12, wherein the at least one drape fastener comprises a bendablematerial and is configured to be wrapped around at least one protrusionon the third surface.
 14. The system of claim 1, wherein the drapecomprises a first region including a first drape fastener and a secondregion including a second drape fastener, the first region configured tobe positioned over the second region and fastened to the second regionby attachment of the first drape fastener to the second drape fastener.15. The system of claim 1, wherein the drape comprises a cover made of amaterial more rigid than the flexible material of the drape, the coverconfigured to enclose a pin positioned on a third surface of the firstportion of the robotic surgery apparatus and configured to be insertedinto an opening of at least one of a surgical instrument insertiondevice or a camera insertion device of the robotic surgery apparatus,the cover configured to provide a sterile barrier between the pin andthe opening of at least one of the surgical instrument insertion deviceor the camera insertion device of the robotic surgery apparatus.
 16. Thesystem of claim 1, wherein the drape comprises an insert made of amaterial more rigid than the flexible material of the drape, the insertconfigured to be positioned in an opening in the first portion of therobotic surgery apparatus that receives a portion of an endoscopiccamera of the robotic surgery apparatus, the insert configured toprovide a sterile barrier between the endoscopic camera and the firstportion.
 17. The system of claim 16, wherein the insert includes firstand second elongated side surfaces connected at one end and notconnected at an opposite end to form a slot, the slot configured to beinserted into the opening of the first portion and to receive theendoscopic camera.
 18. The system of claim 1, wherein the drapecomprises a first pocket configured to receive and at least partiallyenclose a first hand of a user, the first pocket configured tofacilitate positioning of the drape on the first portion of the roboticsurgery apparatus.
 19. The system of claim 18, wherein the drape furthercomprises a second pocket configured to receive and at least partiallyenclose a second hand of a user, the second pocket configured tofacilitate positioning of the drape on the first portion of the roboticsurgery apparatus.
 20. The system of claim 19, wherein the first andsecond pockets are positioned to allow a user to lift the drape awayfrom the second surface while maintaining a sterile barrier for thefirst portion of the robotic surgery apparatus.
 21. The system of claim1, wherein the drape coupler is made from material that is more rigidthat the flexible material of the drape.
 22. (canceled)
 23. (canceled)24. The system of claim 1, wherein the actuator covers are configured tobe positioned in a first position prior to attaching the sterile adapterto the surgical instrument interface, the actuator covers being alignedin the first position.
 25. The system of claim 24, wherein the sterileadapter includes a retainer surrounding the actuator covers, theretainer being configured to maintain positioning of the actuator coversin the first position.
 26. The system of claim 25, wherein the retaineris removable to permit at least one of the actuator covers to be movedto a position different than the first position.
 27. The system of claim1, wherein the actuator covers are configured to move in at least onedirection to facilitate at least one of movement or articulation of thesurgical instrument supported by the sterile adapter.
 28. The system ofclaim 24, wherein the actuator covers are centrally aligned in the firstposition.